Effects of different stages of endometriosis on the outcome of in vitro fertilization.
OBJECTIVE
This study was undertaken to evaluate the effects of different stages of endometriosis on the outcome of treatment in an in vitro fertilization (IVF) program.


METHODS
This was a retrospective, matched case-control study in an academic tertiary referral centre. The study group consisted of 87 women with laparoscopically diagnosed endometriosis, and the control group consisted of 87 age-matched women undergoing IVF for different reasons. The primary outcomes were duration of stimulation, total gonadotropin dose requirement, peak serum estradiol level, total number of oocytes retrieved, fertilization rate, embryo quality, implantation rate, and clinical pregnancy rate. The effect of obliteration of the cul-de-sac by endometriosis was also evaluated.


RESULTS
Women with endometriosis required significantly higher gonadotropin doses than women in the control group (P < 0.01). The fertilization rate was significantly lower for women with endometriosis (P < 0.05), although there was no difference in embryo quality or in the number of embryos transferred. In patients with an obliterated cul-de-sac, fewer oocytes were retrieved than in patients in the control group (P < 0.01).


CONCLUSIONS
The presence of endometriosis, including stages III and IV, does not affect IVF outcome. However, women with endometriosis require more gonadotropin stimulation than those with no endometriosis. Women with an obliterated cul-de-sac have fewer oocytes retrieved than women without obliteration.
Al-Fadhli
Raedah
R
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
Kelly
Simon M
SM
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
Tulandi
Togas
T
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
Lin Tan
Seang
S
Department of Obstetrics and Gynecology, McGill University, Montreal QC.
D000328:Adult; D016022:Case-Control Studies; D010064:Embryo Implantation / Q000502:physiology*; D004624:Embryo Transfer; D004715:Endometriosis / Q000150:complications*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D006801:Humans; D009865:Oocytes / Q000502:physiology; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
D005640:Follicle Stimulating Hormone