The impact of IVF procedures on endometriosis recurrence.
OBJECTIVE
In infertile women with endometriosis requiring an in vitro fertilization (IVF) procedure, the potential risk of an IVF-related progression of the disease remains a matter of debate. Thus, since available data on this issue are scanty and controversial, an observational study has been herein conducted in order to clarify this issue.


METHODS
We recruited 233 women with endometriosis who underwent IVF cycles in our unit. Patients were contacted to assess whether they experienced recurrences of the disease after IVF. The main outcome was to evaluate the impact of the number of IVF cycles and the responsiveness to ovarian hyperstimulation on the likelihood of recurrence. Clinical characteristics of women who did and did not have a recurrence were compared.


RESULTS
One hundred and eighty-nine women were included, 41 of whom (22%) had a diagnosis of endometriosis recurrence. The 36 months cumulative recurrence rate was 20%. The number of IVF cycles and the responsiveness to ovarian hyperstimulation were not associated with the risk of disease recurrence. The adjusted OR for recurrences according to the number of started cycles was 0.92 (95% CI: 0.77-1.10) per cycle (p=0.35). The adjusted OR for recurrences in women with intact versus compromised ovarian reserve was 0.80 (95% CI: 0.40-1.58) (p=0.52).


CONCLUSIONS
IVF procedures do not seem to influence the likelihood of endometriosis recurrence.
Infertility Unit, Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena, Milan, Italy. laurabenaglia@hotmail.it
Laura
L
Benaglia
Edgardo
E
Somigliana
Paolo
P
Vercellini
Francesca
F
Benedetti
Roberta
R
Iemmello
Valentina
V
Vighi
Giulia
G
Santi
Guido
G
Ragni
D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000209:etiology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D010062:Ovulation Induction / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome