In vitro fertilization outcome in women with unoperated bilateral endometriomas

Capsule:
The presence of bilateral endometriomas at the time of IVF affects responsiveness to hyperstimulation but does not affect the quality of the oocytes retrieved and the chances of pregnancy.

Authors:
Laura Benaglia, M.D., Alfonso Bermejo, M.D., Edgardo Somigliana, M.D., Ph.D., Sonia Faulisi, M.D., Guido Ragni, M.D., Luigi Fedele, M.D., Juan A. Garcia-Velasco, M.D.

Volume 99, Issue 6, Pages 1714-1719, May 2013

Abstract:

Objective:
To evaluate IVF outcome in women with unoperated bilateral endometriomas.

Design:
Multicenter retrospective cohort study.

Settings:
Two infertility units.

Patients:
Thirty-nine women with bilateral endometriomas matched to 78 unexposed controls.

Interventions:
Analysis of data from patients who underwent in vitro fertilization (IVF)–intracytoplasmic sperm injection.

Main Outcome measures:
Ovarian responsiveness and oocyte quality.

Results:
Responsiveness to ovarian hyperstimulation was significantly reduced in women with bilateral endometriomas. The total number of developing follicles in cases and controls was 9.6 ± 3.3 and 14.1 ± 6.8, respectively. The number of oocytes retrieved was 7.1 ± 3.2 and 9.8 ± 5.5, respectively. Conversely, oocyte retrieval was not hampered by the presence of the ovarian endometriomas. The rate (Interquatile Range-IQR) of oocytes retrieved per total number of developing follicle in cases and controls was 77% (57-88%) and 71% (63-79%), respectively. Moreover, the quality of the retrieved oocytes did not differ. The fertilization rate (IQR) was 67% (56-100%) and 70% (57-100%), respectively. The rate (IQR) of top quality embryos per oocyte used was 33% (25-50%) and 33% (20-43%), respectively. The implantation rate was 22% and 23%, respectively. The clinical pregnancy rate and the delivery rate also did not differ.

Conclusions:
Although the presence of bilateral endometriomas at the time of IVF affects responsiveness to hyper-stimulation, the quality of the oocytes retrieved and the chances of pregnancy are not influenced.

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