Prognosis in fertilisation rate and outcome in IVF cycles in patients with and without endometriosis: a population-based comparative cohort study with controls

Jeroen Metzemaekers, J Metzemaekers, E.E.R. Lust, Eer Lust, Jpt Rhemrev, Johann Rhemrev, N Van Geloven, Nan van Geloven, Arh Twijnstra, Andries R. H. Twijnstra, Lucette van der Westerlaken, L Van Der Westerlaken, Frank Willem Jansen, F W Jansen
Facts, views & vision in ObGyn · 2021 · vol. 13(1) , pp. 27–34 · doi:10.52054/fvvo.13.1.007 · PMID:33889858 · W3146949380
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found similar fertilization rates in IVF cycles for patients with and without endometriosis, though oocyte retrieval was lower in younger endometriosis patients.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This population-based comparative cohort study analyzed 191 IVF cycles in patients with endometriosis and 312 control IVF cycles (unexplained infertility and tubal pathology) at Leiden University Medical Center, comparing fertilisation rates as the primary outcome. The mean fertilisation rate after IVF was similar between groups (64.1%±25.5 vs 63.9%±24.8; p=0.95), with no difference reported independent of age and r-ASRM classification. The endometriosis group had a lower number of retrieved oocytes (7.0 vs 8.0), with a significant difference only when corrected for age and observed specifically among participants aged ≤35 years; other measured outcomes did not differ. This paper is centrally about endometriosis—specifically fertilisation rates and IVF outcomes in IVF cycles comparing patients with versus without endometriosis.

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Abstract

BACKGROUND: Subfertility occurs in 30-40% of endometriosis patients. Regarding the fertilisation rate with in vitro fertilisation (IVF) and endometriosis, conflicting data has been published. This study aimed to compare endometriosis patients to non-endometriosis cycles assessing fertilisation rates in IVF. METHODS: A population-based cohort study was conducted at the Leiden University Medical Center. IVF cycles of endometriosis patients and controls (unexplained infertility and tubal pathology) were analysed. The main outcome measurement was fertilisation rate. RESULTS: 503 IVF cycles in total, 191 in the endometriosis group and 312 in the control. The mean fertilisation rate after IVF did not differ between both groups, 64.1%±25.5 versus 63.9%±24.8 (p=0.95) respectively, independent of age and r-ASRM classification. The median number of retrieved oocytes was lower in the endometriosis group (7.0 versus 8.0 respectively, p=0.19) and showed a significant difference when corrected for age (p=0.02). When divided into age groups, the statistical effect was only seen in the group of ≤ 35 years (p=0.04). In the age group ≤35, the endometriosis group also showed significantly more surgery on the internal reproductive organs compared to the control group (p<0.001). All other outcomes did not show significant differences. CONCLUSION: Similar fertilisation rates were found in endometriosis IVF cycles compared to controls. The oocyte retrieval was lower in the endometriosis group, however this effect was only significant in the age group ≤ 35 years. All other secondary outcomes did not show significant differences. In general, endometriosis patients with an IVF indication can be counselled positively regarding the chances of becoming pregnant, and do not need a different IVF approach.

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endometriosisinfertility

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