{"paper_id":"5bc3daf9-471d-4a44-bf0c-28571b722318","body_text":"Endometriosis, as diagnosed by direct observation (laparoscopy), was present, either\nas a primary or secondary diagnosis, in 753 out of 39,418 initiated fresh cycles\n(1.9%). Laparoscopic observation included 67% of peritoneal fulguration, 22% of\nsurgery for ovarian cysts, deep infiltration, or a combination of both, and 11%\ncases where no specific description was registered. A comparison was made between\nthe outcome of cases where endometriosis was diagnosed, and a ‘control group’\n(n=2839) of tubal and endocrine factors excluding premature ovarian insufficiency\n(Supplementary Table 7). In this ‘control group’, cases with a secondary diagnosis\nof endometriosis were also ruled out. Supplementary Table 7 provides information on\nthe numbers and the mean number of oocytes collected, as well as the delivery rates\nin these two groups of women, stratified by age categories. Although the mean number\nof oocytes collected at all ages was significantly lower in the presence of\nendometriosis (<35: 9.51 [5.57]  versus  10.50 [6.86]:\n p <0.0001 (95% CI 0.6661 to 1.3139); 35-39: 6.87 [5.49]\n versus  10.28 [6.87]:  p <0.0001 (95% CI\n3.1253 to 3.6947); >39: 5.59 [5.11]  versus  6.12 [5.44]:\n p =0.0053 (95% CI 0.1578 to 0.9022), the delivery rate per\nembryo transfer was not significantly different between the endometriosis and\ncontrol groups (<35: 37.3% versus 35.2%:  p =0.6370 (95% CI\n-6.3307% to 11.0585%); 35-39: 29.3%  versus  24.0%:\n p =0.1027 (95% CI -1.0005% to 12.1257%); >39: 15.2%\n versus  12.6%:  p =0.5579 (95% CI -4.9503% to\n13.5113%).\n\nIn 2020, for the first time, collaborating institutions were asked to describe the\ntype of endometriosis when this was part of a primary or secondary diagnosis. This\nincluded how the diagnosis was reached, and when reached surgically (mostly\nlaparoscopic), centers were asked to describe the type of surgery performed,\nclassified into five categories: peritoneal fulguration, cystectomy, or drainage of\nendometrioma, deep infiltration, partial oophorectomy and a combination of the\nabove. Endometriosis was diagnosed by direct visualization in 753 out of 39,418\ninitiated cycles (1.9%). The number of oocytes collected as well as the delivery\nrate, stratified by age, were compared in women having endometriosis either as a\nprimary or secondary diagnosis, excluding freeze-all cycles, and women having tubal\nand/or endocrine factors, excluding ovarian insufficiency. As seen in Supplementary\nTable 7, in spite of the fact that the number of eggs recovered in cases with\nendometriosis was significantly lower at all ages the delivery rates appeared to be\nhigher in women with endometriosis compared with women with tubal or endocrine\nfactors, although the difference was not statistically significant. These findings\nfollow a similar direction of a study by Opøien et al. (2011) who showed\nbetter ART outcomes in minimal or mild endometriosis after surgical removal of\nendometriotic tissue; and a review by Senapati et al. (2016), using the SART\ndatabase, showing, that in the absence of comorbidity, endometriosis yields fewer\noocytes but higher pregnancy and delivery rates.\nThe authors would like to apologize for any inconvenience caused.","source_license":"CC-BY-4.0","license_restricted":false}