Pregnancy Rate after First Intra Cytoplasmic Sperm Injection-In Vitro Fertilisation Cycle in Patients with Endometriomawith or without Deep Infiltrating Endometriosis

Background: To evaluate the impact of the association of endometrioma with or withoutdeep infiltrating endometriosis (DIE) after a first intra cytoplasmic sperm injection- invitro fertilization (ICSI-IVF) cycle on pregnancy rate.Materials and Methods: In this retrospective study, women with endometrioma whounderwent a first ICSI-IVF cycle from January 2007 to June 2010 were reviewed forpregnancy rate. The main outcome measure was the clinical pregnancy rate. A multiplelogistic regression (MLR) was performed; including all variables that were correlatedto the conception rate. Only independent factors of pregnancy rate were included in aRecursive Partitioning (RP) model.Results: The study population consisted of 104 patients (37 without DIE and 67 patientswith associated DIE). Using multivariable analysis, a lower pregnancy rate was associatedwith the presence of DIE (OR=0.24 (95% CI: 0.085-0.7); p=0.009) and the use ofICSI (OR=0.23 (95% CI: 0.07-0.8); p=0.02). A higher pregnancy rate was associatedwith an anti-mullerian hormone (AMH) serum level over 1 ng/ml (OR=4.3 (95% CI:1.1-19); p=0.049). A RP was built to predict pregnancy rate with good calibration [ROCAUC (95% CI) of 0.70 (0.65-0.75)].Conclusion: Our data support that DIE associated with endometrioma in infertilepatients has a negative impact on pregnancy rate after first ICSI-IVF cycle. Furthermore,our predictive model gives couples better information about the likelihood ofconceiving.