In vitro fertilization is a successful treatment in endometriosis-associated infertility

Capsule:
In a large cohort study, women with endometriosis associated infertility were found to have pregnancy and live birth rates similar to women with tubal factor infertility.

Authors:
Hans Kristian Opøien, M.D., Peter Fedorcsak, M.D., Ph.D., Anne Katerine Omland, M.D., Ph.D., Thomas Åbyholm, M.D., Ph.D., Sverre Bjercke, M.D., Ph.D., Gudvor Ertzeid, M.D., Ph.D., Nan Oldereid, M.D., Ph.D., Jan Roar Mellembakken, M.D., Ph.D., Tom Tanbo, M.D., Ph.D.
Volume 97, Issue 4 , Pages 912-918, April 2012

Objective:
To assess success rates of IVF and intracytoplasmic sperm injection in women with various stages of endometriosis.

Design:
Retrospective cohort study.

Setting:
Reproductive medicine unit in a university hospital.

Patient(s):
Infertile women (n = 2,245) with various stages of endometriosis or tubal factor infertility.

Intervention(s):
IVF or intracytoplasmic sperm injection.

Main Outcome Measure(s):
Dose of FSH, number of oocytes retrieved, fertilization rate, implantation rate, pregnancy rate (PR), live birth/ongoing PR.

Result(s):
Women with endometriosis had similar pregnancy and live birth/ongoing PR as did women with tubal factor infertility, but the American Society for Reproductive Medicine (ASRM) stage I and II endometriosis patients had a lower fertilization rate, and stage III and IV patients required more FSH and had fewer oocytes retrieved. Splitting the stage III and IV groups into patients with and without endometriomas showed that the endometrioma group required more FSH and had a significantly lower pregnancy and live birth/ongoing PR.

Conclusion(s):
With the exception of patients with endometrioma, infertile women with various stages of endometriosis have the same success rates with IVF and intracytoplasmic sperm injection as patients with tubal factor. This contrasts with the systematic review on which the European Society of Human Reproduction and Embryology bases its recommendations.

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