P-324 Obstetric outcomes of endometriosis patients and other etiologies were compared after IVF

Abstract Study question Do endometriosis patients have worse obstetric outcomes as compared to other infertility etiologies after IVF ? Summary answer Endometriosis patients had similar pregnancy outcomes except for high incidence of placenta previa, placenta acreta spectrum and IUGR. What is known already In women with endometriosis,a possible underlying process may be associated with a higher likelihood of adverse obstetric outcomes.Live birth rates decreased and an miscarriage rate increased in women with endometriosis.In endometriosis undergoing inflammation has been proposed to be involved in poor pregnancy outcome.Women with endometriosis may have a higher risk of abnormal implantation and placentation.Delayed implantation is thought to lead to placental insufficiency leading to embryo misimplantation,placenta previa and/or accreta,or intrauterine growth restriction (IUGR) and/or preeclampsia.Premature decidual aging can also lead to premature birth and fetal death,while shallow trophoblast invasion of maternal decidua and/or blood vessels can lead to preeclampsia. Study design, size, duration In this retrospective study, the cycles of patients who underwent 6682 IVF attempts between June 2014 and June 2023 were analyzed. Participants/materials, setting, methods The study consisted of IVF cycles of patients with a diagnosis of endometriosis(611 cycles),male factor(953 cycles),unexplained infertility(4595 cycles),tubal factor(288 cycles),and anovulatory(203 cycles) infertility etiology.Demographic data(age, duration of infertility,body mass index (BMI)),pregnancy outcome (clinical pregnancy (CPR),clinical abortion, ongoing (OGR) and live birth rate (LBR)) and complications (preterm birth (PB), pre-eclampsia, IUGR, SGA (Small gestational age), gestational diabetes mellitus (GDM), placenta acreta spectrum (PAS) placenta previa (PP)) were extracted from patient files and compared between the groups. Main results and the role of chance CPR was statistically significant in the anovulation group(%52,5) compared to the other groups (p<0.001), but there was no statistically significant difference between the other groups. While OPR and LBR were statistically significantly higher in the unexplained infertility group(%33,7 and %34) compared to the tubal factor group(%28,3 and %29)(p<0.001), no significant difference was observed compared to the other groups. OPR and LBR was statistically significantly higher in the tubal factor group than in the anovulation group (%18,7 and %21,3)(p<0.001), but there was no statistically significant difference between the other groups.PAS and PP was statistically significantly higher in the endometriosis(%16,5 and %16,5) and anovulation group(%11,8 and %11,8) compared to the other groups (p<0.001 and p=0.01),but there was no statistically significant difference between the other groups. PAS and PP incidence was also higher in endometriosis compared to anovulation (p<0.001 and p=0.01).While PTB was statistically more common in the anovulation group(%18,2) compared to the other groups except endometriosis(%14,7)(p=0.01). PTB was statistically significantly higher in the endometriosis group than in the male factor(%5,1) group (p=0.01), but there was no statistically significant difference between the other groups. Among the groups; there was no statistically significant difference in the rates of abortion, preeclampsia, SGA, IUGR and GDM(p>0.05). Limitations, reasons for caution The main limitations of our study are its retrospective design. Data of some pregnancy complications like postpartum hemorrhage, has not been reported in patient files. Subtypes of endometriosis may have specific complication profiles, but more evidence is needed to draw conclusions. Wider implications of the findings Complications are caused by uterine changes that lead to implantation and placentation problems,can therefore have far-reaching consequences.Our findings assess the obstetric outcomes of women with endometriosis and other infertility groups,suggesting that women should seek prenatal counseling and should be considered at higher risk in pregnancy and childbirth until otherwise found. Trial registration number Yes