Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome

Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome Jui-Chun Chang, Yu-Chiao Yi, Ya-Fang Chen, Hwa-Fen Guu, Hsiao-Fan Kung, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2329900/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Apr, 2023 Read the published version in Archives of Gynecology and Obstetrics → Version 1 posted 5 You are reading this latest preprint version Abstract Purpose : These study aims to assess the impact of endometrioma on patients who undergo ART treatment due to endometriosis. Methods : Retrospective study was conducted in women ≤ 40 years of age who underwent ART treatment at an academic medical center between January 2014 and December 2020. Two-hundred-and-eight women had received IVF/ICSI treatment due to endometriosis and there were 89 patients’ presence of endometrioma. Patients were further divided into primary endometrioma, recurrent endometrioma and those having received cystectomy for endometrioma prior to IVF/ICSI. The control group included 624 infertile women without endometriosis. Results : In the endometrioma subgroup (B) the blastocyst formation rate was significantly lower when compared with the endometriosis (A) and control groups (C). The cumulative live birth rates (CLBRs) (60.5% versus 49.4% versus 56.9%, p=0.194 in A versus B, p=0.406 in A versus C, p=0.878 in B versus C) were comparable. Multiple logistic regression analysis revealed that female age, total FSH dose and blastocyst formation rate were the significant variables in predicting CLBR (OR: 0.89, CI: 0.80–0.99, p < 0.025, OR:0.68 CI:0.53-0.88, p=0.003 and OR: 30.04, CI: 9.93–90.9, p < 0.001, respectively). The CLBRs were comparable 47.1%, 60% and 57.9% in the primary endometrioma, s/p cystectomy and recurrent endometrioma group . Conclusion: Although the blastocyst formation rate was lower in the endometrioma group, CLBR was not worse than those who were in the endometriosis or control group. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if ovarian reserve was comparable. Recurrent endometrioma did not worsen IVF/ICSI outcomes than primary endometrioma. Endometriosis endometrioma IVF/ICSI outcome cystectomy cumulative live birth rates Figures Figure 1 Figure 2 Figure 3 Introduction Endometriosis is a chronic disease known to be detrimental to fertility [1]. Approximately 25–50% of women experiencing infertility may be affected by endometriosis, with 30–50% of women diagnosed with endometriosis being infertile [2]. A significant number of women with endometriosis eventually seek In Vitro Fertilization (IVF) with or without Intracytoplasmic Sperm Injection (ICSI) for conception. An endometrioma is the formation of a cyst within the ovary with ectopic endometrial tissue lining [3]. It is found in 17–44% of patients with endometriosis [4]. The exact mechanism through which endometrioma causes infertility remains uncertain. Several proposed mechanisms include a distorting tubo-ovarian anatomy [5], reduction in the quality and quantity of developing follicles by anatomical proximity of the ovarian cyst to the nearby follicular pool [6,7], and a reduced ovarian reserve and embryo quality due to local inflammation milieu, toxic content and oxidative damage [8,9]. Although with a higher cancel rate and lower oocyte retrieval, current evidence shows that women with endometrioma have similar IVF/ICSI outcomes in terms of live birth rate when compared to those without endometriosis [10]. However, there have been only a few studies comparing IVF/ICSI outcomes between women with endometrioma and women with endometriosis. Current molecular, histological and morphological evidence suggests that endometrioma is detrimental to the ovaries [6,11]. The endometrioma, being different from endometriosis, likely has a specific impact on IVF/ICSI outcomes. Therefore, the first part of this study was aimed to compare IVF/ICSI outcomes between women with endometrioma and women with endometriosis. In the second part of our study, we aimed to determine the impact of cystectomy on IVF/ICSI outcomes. Current guidelines are unclear regarding surgical removal of an endometrioma prior to IVF/ICIS [12]. Surgical treatment of endometrioma has been shown to increase natural fecundity [13]. Additionally, an endometrioma left in situ during IVF/ICSI may cause technical difficulties during oocyte retrieval, progression of the endometrioma after artificial reproductive technology (ART), and higher risks of infection [14-16]. Evidence has shown that surgical treatment on endometrioma could be detrimental to ovarian reserve [17,18], subsequently adversely affecting reproductive outcomes of IVF/ICSI [19]. Therefore, the second part of our study was aimed to determine the impact of cystectomy for endometrioma on the IVF/ICSI outcomes. Materials and Methods We retrospectively analyzed patients (n=2,153) who had undergone IVF/ICSI between January 2014 and December 2018, at the Center for Reproductive Medicine, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, Taiwan. We included those cycles with the patient’s major reason for IVF/ICSI being endometriosis. Endometriosis was confirmed by laparoscopic surgery, presence of endometrioma or when pelvic examination revealed cul-de-sac nodularity with dysmenorrhea. Endometrioma was confirmed by visualizing on two or more separate examinations done at intervals which were at least one month apart, an ovarian cyst with regular margins and ground-glass echogenicity on transvaginal ultrasonography (TVUS) [20]. The endometrioma was measured along three dimensions, with the average diameter calculated during a baseline ultrasonography on D2/D3 in the month of controlled ovarian stimulation (COS). We excluded those cycles with patients aged > 40 years or <20 years, had simulation duration<5 days, with severe male factor (including Testicular Sperm Extraction), uterine factor (including adenomyosis asdefined by TVUS), preimplantation genetic testing for aneuploidies (PGT-A), donor eggs or immunological factors. Patients whose embryos were not completely transferred back, or who had received embryo transfer from different oocyte pick up cycles were also excluded. The control group included women who underwent IVF/ICSI for non-endometriosis-related infertility during the same study period. Endometriosis was ruled out in a pre-ART work-up assessment, including a clinical examination, questioning (regarding the extent of pelvic pain and a prior history of surgery) and TVUS. The control group was matched in age and Anti-mullerian Hormone (AMH) levels in 1 to 3 subject ratio. Blind matching to the results was performed. In the first analysis, we compared reproductive outcomes amongst patients with endometrioma present during IVF/ICSI treatment, those with only endometriosis, and the control group. In the second analysis, we compared outcomes between patients in the “Recurrent endometrioma group” who were defined as patients with endometrioma during IVF/ICSI and had a prior history of cystectomy for endometrioma. The “Primary endometrioma group” was defined as those who did not have a prior cystectomy and was with endometrioma during IVF/ICSI. Finally, the “status post (s/p) cystectomy group” was defined as patients who had received cystectomy for endometrioma prior to IVF/ICSI treatment and had shown no presence of endometrioma during IVF/ICSI. This study was approved by the Institutional Review Board of Taichung Veterans General Hospital (IRB No. CE21306B) Patients underwent COS, oocyte retrieval and embryo transfer according to procedures as previously described [21]. Which protocol (either agonist or antagonist protocol) to use for the patient was at the discretion of the care physician. Stimulation was monitored by transvaginal ultrasound. Ovulation triggering was induced by injecting the recombinant hCG (Ovidrel, Merck Serono) and/or GnRH agonist. Ultrasound-guided transvaginal oocyte retrieval was carried out approximately 36 hours post-triggering. Oocytes were either inseminated or underwent ICSI approximately 4 hours after collection. For the fresh group, cleavage stage embryos or blastocysts were transferred. The surplus embryos were cryopreserved through vitrification. The endometrial preparations during the following frozen embryo transfer (FET) cycles were programmed by either hormone replacement cycles or modified natural cycles, depending on the individual condition of each patient. Details of the endometrium priming and luteal phase support have been reported earlier [21]. Outcomes and statistical analyses We followed up patients through to June 2021. Our primary outcome was cumulative live birth rate (CLBR), determined in those who had achieved through fresh and/or vitrified embryos obtained from the same oocyte retrieval cycle. Clinical pregnancy was defined as the presence of at least one embryo having cardiac activity. Live birth was defined as the delivery of a live infant after at least 24 weeks of gestation. Live birth rates (LBR) were calculated individually in the fresh ET cycle and in the first FET cycle if no fresh ET had been performed. Blastocyst formation rates only included those patients who were intended to receive blastocyst transfer. Data were presented as mean + standard deviation (SD), or as percentage. Group comparisons were performed using Mann-Whitney and Pearson’s Chi square tests in SPSS (Version 18). Logistic regression analysis was conducted on clinical covariates assessed for their association with CLBR. Multivariable logistic regression (MLR) analysis was performed on variables that were significant at univariable analysis (P < 0.05). Differences were considered significant at p <0.05. Results We analyzed a total of 208 IVF/ICSI cycles which had indications of endometriosis. These cycles consisted of 119 with endometriosis and 89 with endometrioma. The flow chart of these cycles is shown in Figure 1 . In 89 cycles with endometrioma, 19 had received cystectomy for endometrioma prior to IVF/ICSI, and were included in the “recurrent endometrioma group”. The remaining 64 cycles were included in the “primary endometrioma group”. In 119 cycles with no endometrioma during IVF/ICSI, 40 had priorly received cystectomy for endometrioma, and were included in the “s/p cystectomy group”. After matching, we had 624 cycles without endometriosis during IVF/ICSI as the control group. First analyses of the baseline characteristics and outcomes are presented in Table 1 . Comparable characteristics in the endometriosis (A), endometrioma (B) and control (C) groups Patients in the control group had a significantly higher Body Mass Index (BMI) and received more ICSI In the endometrioma group, the mean size of endometrioma was 3.9 cm (range 1 to 9 cm). The gonadotropin dose given was significantly higher in the endometrioma group compared with the other groups (FSH dosage 3047 1037.9 IU versus 3619IU 1223 versus 31301065.5 IU, p=0.001 in A versus B, p= 0.4 in A versus C, p= 0.001 in B versus C; LH dosage 941 573.9 IU versus 1224721.5 IU versus 963601.2 IU, p=0.009 in A versus B, p= 0.823 in A versus C, p= 0.003 in B versus C). The number of follicles > 14 mm on the day of triggering, number of oocytes retrieved, and number of mature oocytes were lower in the endometrioma group than the control group. The blastocyst formation rate was significantly lower in the endometrioma group when compared with the other two groups (57.7% versus 49.4% versus 56%, p=0.005 in A versus B, p=0.376 in A versus C, p=0.008 in B versus C). Clinical pregnancy rate (CPR) in fresh ET, LBR in fresh ET, and CLBR were comparable in the three groups. LBR in the first FET in freeze-all cycle was significantly lower in the endometrioma group when compared with the control group (53.8% versus 36.8% versus 59.2%, p=0.134 in A versus B, p= 0.536 in A versus C, p=0.011 in B versus C) (Figure 2). Results of MLR analyses in predicting CLBR are presented in Table 3. Female age, total FSH dosage and blastocyst formation rates were found to be significant variables in predicting CLBR (OR: 0.89, CI: 0.80–0.99, p < 0.025; OR:0.68 CI:0.53-0.88, p=0.003 and OR: 30.04, CI: 9.93–90.9, p < 0.001, respectively). In the second analysis, the baseline characteristics and clinical outcomes of primary endometrioma (D), s/p cystectomy (E) and recurrent endometrioma (F) are shown in Table 3. The female age was lower in the s/p cystectomy group than the endometrioma group (34.6 3.6 versus 32.8 3.4, p=0.007). Serum AMH, BMI, stimulation protocol and fertilization method were similar in each group. Total gonadotropin dose and length of COS were lower in the s/p cystectomy group (FHS dose 3561.9 1211.4 IU versus 2844 IU1109.2 versus 3820.81277.3 IU in group D, E, F, p=0.001 in D versus E, p=0.47 in D versus F, p= 0.004 in E versus F; LH dose 1207.5718.8 versus 915 642.8 versus 1286.8747.6, p=0.03 in D versus E, p=0.722 in D versus F, p= 0.09 in E versus F; length of stimulation 10.5 2.4 versus 9.3 1.5 versus 9.8 1.7, p=0.012 in D versus E, p=0.33 in D versus F, p= 0.421 in E versus F). The number of follicles measuring > 14 mm on the day of triggering as well as estradiol levels were lower in the recurrent endometrioma group. The blastocyst formation rate was highest in the s/p cystectomy group (49.7% versus 61.5% versus 47.8%, p= 0.004 in D versus E, p=0.69 in D versus F, p= 0.042 in E versus F). CPR in fresh ET, LBR in fresh ET, LBR in first FTE in freeze-all cycle and CLBR were all similar in the primary endometrioma, s/p cystectomy and recurrent endometrioma groups (Figure 3). Discussion Our results show that in patients with endometriosis being the major indication for IVF/ICSI, the CLBRs were similar to the controls (non-endometriosis). Although the presence of endometrioma had comparable CLRBs, the prescribed gonadotropin dose was significantly higher, with the blastocyst formation rate being significantly lower when compared with those patients with only endometriosis. In the second analysis, CLBRs were comparable across the primary endometrioma, s/p cystectomy and recurrent endometrioma groups. The blastocyst formation rate was significantly higher in the s/p cystectomy group when compared with the other two groups. A number of studies have investigated the effects of endometriosis on ART outcomes. In general, women with endometriosis have similar ART outcomes to those of controls in terms of LBR [22-24]. Our results are compatible with these. Regarding the relationship between the presence of endometrioma and ART outcomes, our findings are less consistent. A recent systematic review found that women with endometrioma have fewer oocytes and MII oocytes retrieved when compared to those without endometriosis, but no such differences in CPR, IR or LBR [25]. Our results are similar to theirs, showing that endometrioma was associated with higher gonadotropin consumption, a lower number of oocytes retrieved, and lower blastocyst formation rate, when compared with controls. The final outcome, CLBR, was the same as the control group. When comparing patients with endometrioma and endometriosis, our results revealed the similarities of LBR and CLBR in patients with either endometrioma or endometriosis. These findings are consistent with previous studies which have shown a similarity in delivery rates and pregnancy rates in patients with unoperated endometrioma and with only endometriosis [26.27]. These studies were however conducted in the 2000s, and CLBR was not analyzed at the time. In comparing primary endometrioma and cystectomy prior to IVF/ICSI, we found that although the patients in the s/p cystectomy group were younger in age, their ovarian reserves were similar, likely due to the surgical excision of endometrioma having lowered the ovarian reserve [17]. In our center, it is our policy is to choose younger patients with moderate ovarian reserves as candidates for receiving cystectomy for endometrioma due to fertility reasons. We encourage these patients to undergo IVF/ICSI if they have not gotten pregnant after a one-year trial post-surgery Despite concerns surrounding a reduced ovarian reserve, surgical removal of endometrioma may improve chances of spontaneous pregnancy through restoration of the ovarian functional anatomy. This approach has been considered to be a primary treatment method for infertility patients in the case of endometrioma [12]. Additionally, such an operation also improves pain symptoms [28]. Regarding the impact of excised endometrioma on ART outcomes, we found similarities between the primary endometrioma and s/p cystectomy groups in terms of the number of oocytes retrieved, number of mature oocytes, LBR and CLBR. Our findings are consistent with most reports published in the available literature, including a recent meta-analysis [29]. Other studies have reported different results showing that endometrioma surgery diminished ovarian reserves, leading to lower pregnancy rates after IVF [30.31]. However, these studies were conducted on limited numbers of patients, with differences in surgical procedures and varying surgeon expertise. Our results regarding CLBR per oocyte retrieval further confirm that with comparable ovarian reserves, cystectomy prior to operation produced similar IVF/ICSI outcomes when compared with endometrioma in situ . In comparing primary and recurrent endometriomas, our results show weaker ovarian responses to COS in the recurrent endometrioma group. This finding is inconsistent with a previous study which reported that patients with recurrent endometriomas have the same ovarian response [32]. In contrast, the outcomes of IVF/ICSI, including LBR and CLBR in our study, were compatible between these two groups, and was consistent with that previous study [32]. There was a study showing that histologically confirmed surgery for recurrent endometrioma is associated with a greater loss of ovarian tissue, which is more harmful to ovarian reserves when compared with endometriomas which were operated on for the first time [33]. Park et al ., also reported that second-line surgery for recurrent endometrioma has a deleterious effect on IVF outcomes, including ovarian response and CPR, when compared with in situ recurrent endometrioma [34]. It has also been reported that spontaneous cumulative pregnancy rates drop to almost half after second-line surgery for endometrioma when compared with those obtained after primary surgery [35]. Therefore, a conservative management plan to treatment for recurrent endometrioma is more suitable for women who seek fertility. Our study has shown presence of endometrioma is associated with fewer blastocyst formations, when compared with the endometriosis or the control group. Such effects seemed to disappear after performing cystectomy on endometrioma. The poorer ovarian response and lower blastocyst formation rates were unlikely consequences of the deleterious effects which surgery had on the endometriomas, and were more likely due to endometrioma per se . There are growing studies which have shown that ovarian quality may be deteriorated by endometrioma [36]. One recent study which used scRNA-seq compared oocytes from patients with endometrioma and healthy oocytes. The results revealed a differential transcriptomic profile indicating a lower oocyte quality in endometrioma [37]. These mechanisms may explain how the blastocyst formation rate we found was lower in the endometrioma group. Our study possesses certain strengths. First, our primary outcome is CLBR per oocyte retrieval which has been seldom mentioned in previous studies and is a better indicator of quality and success in IVF/ICSI, as cryopreservation is an integral part of IVF [38]. Second, all our patients had undergone ovarian stimulation and IVF performed at a single medical center. In this regard, all measurements (AMH and TVUS) were performed consistently. Third, we compared the presence of endometrioma with endometriosis. This issue is not commonly addressed, but still has practical implications. Our results show that for the first time, the presence of endometrioma negatively influenced ovarian responsiveness and blastocyst formation rates. The main limitation of this work are its retrospective design nature and the number size of the recurrent endometrioma group being small(n=19). In addition, the endometriosis group was heterogeneous, including patients with peritoneal endometriosis or DIE, with some of them having no pathological diagnosis. Nevertheless, it is currently well accepted that TVUS is a highly accurate and reproducible method for non-invasive diagnosis of DIE and ovarian lesions [39]. Another limitation is that we did not stratify patients according to their endometriosis stages, and only stratified those with endometrioma or endometriosis. As an increasing number of patients are receiving conservative treatment prior to IVF/ICSI, the presence or absence of endometrioma is a more useful characteristic in daily practice. Conclusion We have shown that IVF/ICSI outcomes are comparable in those with endometrioma and controls. Although the blastocyst formation rate was lower and gonadotropin consumption was higher in those with endometrioma, IVF/ICSI outcomes in patients with endometrioma were no worse than those with endometriosis. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if the ovarian reserve was comparable. Recurrent endometrioma did not contribute to worse impacts on the IVF/ICSI outcomes when compared with primary endometrioma. Declarations Ethics approval and consent to participate : Institutional Review Board, TCVGH, No. CE21306B Date of approval: August 30, 2021 Acknowledgments : Not applicable Funding : No funding was received for conducting this study Competing interests: The authors have no relevant financial or non-financial interests to disclose. Informed Consent Statement: Not Applicable Availability of data and materials: All data generated and analyzed during this study are included in this published article and its supplementary information files. Consent to Publish : Authors are responsible for correctness of the statements provided in the manuscript Authors' contributions: Jui-Chun Chang and : Protocol/project development, Data Collection, Manuscript writing Ming-Jer Chen: Protocol/project development Hsiao-Fan Kung: prepared the figures and tables Yu-Chiao Yi: prepared the figures and tables. Hwa-Fen Guu :Data collection or management Li-Yu Chen: Data collection or management Ya-Fang Chen: Data analysis Shih-Ting Chuan : Data analysis All authors reviewed the manuscript." References Holoch, K. J. and B. A. Lessey. "Endometriosis and infertility." Clin Obstet Gynecol2010 53: 429-438. Macer, M. L. and H. S. Taylor. "Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility." Obstet Gynecol Clin North Am 2012;39: 535-549. Hughesdon, P. E. "The structure of endometrial cysts of the ovary." J Obstet Gynaecol Br Emp 1957;64: 481-487. Alborzi, S., P. Keramati, M. Younesi, A. Samsami and N. Dadras (). "The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas." Fertil Steril 2014;101(2): 427-434 Young, V. J., J. K. Brown, P. T. Saunders and A. W. Horne. "The role of the peritoneum in the pathogenesis of endometriosis." Hum Reprod Update2013;19: 558-569. Sanchez, A. M., P. Viganò, E. Somigliana, P. Panina-Bordignon, P. Vercellini and M. Candiani. "The distinguishing cellular and molecular features of the endometriotic ovarian cyst: from pathophysiology to the potential endometrioma-mediated damage to the ovary." Hum Reprod Update 2014;20: 217-230. Kuroda, M., K. Kuroda, A. Arakawa, Y. Fukumura, M. Kitade, I. Kikuchi, J. Kumakiri, S. Matsuoka, I. A. Brosens, J. J. Brosens, S. Takeda and T. Yao. "Histological assessment of impact of ovarian endometrioma and laparoscopic cystectomy on ovarian reserve." J Obstet Gynaecol Res 2012;38: 1187-1193 Matsuzaki, S. and B. Schubert. "Oxidative stress status in normal ovarian cortex surrounding ovarian endometriosis." Fertil Steril 2010;93: 2431-2432. Muzii, L., C. Di Tucci, M. Di Feliciantonio, G. Galati, V. Di Donato, A. Musella, I. Palaia and P. B. Panici. "Antimüllerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis." Fertil Steril 2018;110: 932-940. Hamdan, M., G. Dunselman, T. C. Li and Y. Cheong. "The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis." Hum Reprod Update 2015;21: 809-825. Sanchez, A. M., V. S. Vanni, L. Bartiromo, E. Papaleo, E. Zilberberg, M. Candiani, R. Orvieto and P. Viganò. "Is the oocyte quality affected by endometriosis? A review of the literature." J Ovarian Res2017; 10: 43. Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, Saridogan E, Tomassetti C, van Hanegem N, Vulliemoz N, Vermeulen N; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009. Vercellini, P., E. Somigliana, R. Daguati, G. Barbara, A. Abbiati and L. Fedele. "The second time around: reproductive performance after repetitive versus primary surgery for endometriosis." Fertil Steril 2009;92: 1253-1255. Benaglia, L., E. Somigliana, R. Iemmello, E. Colpi, A. E. Nicolosi and G. Ragni. "Endometrioma and oocyte retrieval-induced pelvic abscess: a clinical concern or an exceptional complication?" Fertil Steril 2008;89: 1263-1266. Nieweglowska, D., I. Hajdyla-Banas, K. Pitynski, T. Banas, O. Grabowska, G. Juszczyk, A. Ludwin and R. Jach. "Age-related trends in anti-Mullerian hormone serum level in women with unilateral and bilateral ovarian endometriomas prior to surgery." Reprod Biol Endocrinol 2015;13: 128. Somigliana, E., L. Benaglia, A. Paffoni, A. Busnelli, P. Vigano and P. Vercellini. "Risks of conservative management in women with ovarian endometriomas undergoing IVF." Hum Reprod Update 2015;21: 486-499. Younis, J. S., N. Shapso, R. Fleming, I. Ben-Shlomo and I. Izhaki "Impact of unilateral versus bilateral ovarian endometriotic cystectomy on ovarian reserve: a systematic review and meta-analysis." Hum Reprod Update2019; 25: 375-391. Ergun, B., M. Ozsurmeli, O. Dundar, C. Comba, O. Kuru and S. Bodur. "Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy." J Minim Invasive Gynecol 2015;22: 997-1003. Benschop, L., C. Farquhar, N. van der Poel and M. J. Heineman. "Interventions for women with endometrioma prior to assisted reproductive technology." Cochrane Database Syst Rev2010 (11): Cd008571. Exacoustos, C., L. Manganaro and E. Zupi. "Imaging for the evaluation of endometriosis and adenomyosis." Best Pract Res Clin Obstet Gynaecol 2014;28: 655-681 Jui-Chun Chang , Ming-Jer Chen, Hwa-Fen Guu , Ya-Fang Chen , Yu-Chiao Yi, Hsiao-Fan Kung, Li-Yu Chen, Min-Min Chou Does the “freeze-all” policy allow for a better outcome in assisted reproductive techniques than the use of fresh embryo transfers? A retrospective study Senapati, S., M. D. Sammel, C. Morse and K. T. Barnhart. "Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database." Fertil Steril 2016;106: 164-171 Prefumo, F. and A. C. Rossi "Endometriosis, endometrioma, and ART results: Current understanding and recommended practices." Best Pract Res Clin Obstet Gynaecol 2018; 51: 34-40. Rossi, A. C. and F. Prefumo. "The effects of surgery for endometriosis on pregnancy outcomes following in vitro fertilization and embryo transfer: a systematic review and meta-analysis." Arch Gynecol Obstet 2016;294: 647-655. Alshehre SM, Narice BF, Fenwick MA, Metwally M. The impact of endometrioma on in vitro fertilisation/intra-cytoplasmic injection IVF/ICSI reproductive outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021 Jan;303(1):3-16. Kuroda, K., M. Kitade, I. Kikuchi, J. Kumakiri, S. Matsuoka, M. Kuroda and S. Takeda. "The impact of endometriosis, endometrioma and ovarian cystectomy on assisted reproductive technology." Reprod Med Biol 2009;8: 113-118. Suzuki, T., S. Izumi, H. Matsubayashi, H. Awaji, K. Yoshikata and T. Makino. "Impact of ovarian endometrioma on oocytes and pregnancy outcome in in vitro fertilization." Fertil Steril 2005;83: 908-913. Leonardi, M., T. Gibbons, M. Armour, R. Wang, E. Glanville, R. Hodgson, A. E. Cave, J. Ong, Y. Y. F. Tong, T. Z. Jacobson, B. W. Mol, N. P. Johnson and G. Condous "When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis." J Minim Invasive Gynecol 2020;27: 390-407. Wu, C. Q., A. Albert, S. Alfaraj, O. Taskin, G. M. Alkusayer, J. Havelock, P. Yong, C. Allaire and M. A. Bedaiwy "Live Birth Rate after Surgical and Expectant Management of Endometriomas after In Vitro Fertilization: A Systematic Review, Meta-Analysis, and Critical Appraisal of Current Guidelines and Previous Meta-Analyses." J Minim Invasive Gynecol 2019 26: 299-311. Maignien, C., P. Santulli, V. Gayet, M. C. Lafay-Pillet, D. Korb, M. Bourdon, L. Marcellin, D. de Ziegler and C. Chapron "Prognostic factors for assisted reproductive technology in women with endometriosis-related infertility." Am J Obstet Gynecol 2017;216: 280.e1-280.e9 Roustan, A., J. Perrin, M. Debals-Gonthier, O. Paulmyer-Lacroix, A. Agostini and B. Courbiere "Surgical diminished ovarian reserve after endometrioma cystectomy versus idiopathic DOR: comparison of in vitro fertilization outcome." Hum Reprod 2015;30: 840-847. Ata, B., S. Mumusoglu, K. Aslan, A. Seyhan, I. Kasapoglu, B. Avci, B. Urman, G. Bozdag and G. Uncu "Which is worse? Comparison of ART outcome between women with primary or recurrent endometriomas." Hum Reprod 2017;32:1427-1431. Muzii, L., C. Achilli, F. Lecce, A. Bianchi, S. Franceschetti, C. Marchetti, G. Perniola and P. B. Panici. "Second surgery for recurrent endometriomas is more harmful to healthy ovarian tissue and ovarian reserve than first surgery." Fertil Steril 2015;103: 738-743. Park, H., C. H. Kim, E. Y. Kim, J. W. Moon, S. H. Kim, H. D. Chae and B. M. Kang. "Effect of second-line surgery on in vitro fertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis." Obstet Gynecol Sci 2015;58: 481-486. Vercellini, P., E. Somigliana, P. Viganò, A. Abbiati, G. Barbara and P. G. Crosignani. "Surgery for endometriosis-associated infertility: a pragmatic approach." Hum Reprod 2009;24: 254-269 Corachán A, Pellicer N, Pellicer A, Ferrero H. Novel therapeutic targets to improve IVF outcomes in endometriosis patients: a review and future prospects. Hum Reprod Update. 2021;27:923-972. Ferrero H, Corachan A, Aguilar A, Qui~nonero A, Carbajo-Garcia MC, Alama P, Tejera A, Taboas E, Munoz E, Pellicer A. Single-cell RNA sequencing of oocytes from ovarian endometriosis patients reveals a differential transcriptomic profile associated with lower quality. Hum Reprod 2019;34:1302–1312 Garrido, N., J. Bellver, J. Remohí, C. Simón and A. Pellicer. "Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success." Fertil Steril 2011;96: 40-46. Exacoustos, C., E. Zupi and E. Piccione. "Ultrasound Imaging for Ovarian and Deep Infiltrating Endometriosis." Semin Reprod Med 2017;35: 5-24 Tables Table 1: Baseline characteristics and results of the first analysi A . Endometriosis (n=119) B . E ndometrioma (n=89) C. Control (n=624) A vs. B P value A vs. C P value B vs. C P value Female age (y; mean ± SD) 34.1 3.1 34.4 3.5 34.3 3.1 0.564 0.523 0.884 BMI (kg/m2) 20.9 2.5 21.3 3.0 22.3 3.6 0.351 <0.001* 0.019* AMH (ng/ml) 3.6 2.9 3.1 2.5 3.5 3.1 0.155 0.449 0.334 Stimulation protocol: Agonist protocol 33/119 (27.7%) 26/89 (29.2%) 158/624 (25.3%) 0.814 0.581 0.432 Antagonist protocol 86/119 (72.3%) 63/89 (70.8%) 466/624 (74.4%) Fertilization method: ICSI 33/199 (27.7%) 30/89(33.7%) 291/624 (46.4%) 0.353 <0.001* 0.022* IVF 86/199(72.3%) 59/89(66.3%) 333/624 (53.4%) Total FSH dosage (IU) 3047.31037.9 3619.41223 31301065.5 0.001* 0.400 0.001 Total LH dosage (IU) 941.0 573.9 1224.4721.5 963601.2 0.009* 0.823 0.003* Stimulation days 9.9 1.6 10.3 2.3 10.1 1.5 0.326 0.188 0.912 EMT (mm), trigger day 11.2 2.8 11.9 3.4 11.0 3.3 0.028* 0.699 0.004* Total > 14mm follicle number 8.5 4.7 7.6 4.8 9.1 5.7 0.147 0.595 0.028* E2 on trigger day (pg/ml) 2779.31753.7 2602.1 2151.9 2799.61993.9 0.168 0.659 0.172 P4 on trigger day (ng/ml) 0.9 0.4 1.0 0.7 1.0 0.6 0.801 0.668 1.000 Number of oocyte retrieval 12.4 8.4 10.3 6.7 12.7 8.5 0.131 0.624 0.017* Number of mature oocytes 9.6 6.6 8.0 5.8 10.0 7.1 0.121 0.552 0.013* Fertilization rate 74.2% 73.8% 69.3% 0.219 0.613 0.28 Good embryos rate at D3 32.0% 31.4% 34.7% 0.780 0.100 0.098 BC formation rate 57.7% 49.4% 56% 0.005* 0.376 0.008* D2/D3 embryo transfer rate 58.9% 71.1% 69.1% 0.181 0.088 0.783 BMI, body mass index; AMH, anti-Müllerian hormone; FSH, follicle-stimulating hormone; LH: luteinizing hormone; EMT: endometrial thickness; BC: blastocyst; E2, estradiol; P, progesterone. *With statistical significance Table 2 Univariate and multivariate analysis of factors affecting the CLBR in patients undergoing IVF/ICSI. Univariate Multivariate OR 95%CI p value OR 95%CI p value Age, years 0.87 (0.83- 0.91) <0.001** 0.89 (0.80- 0.99) 0.025* BMI 1.00 (1.00- 1.00) 0.720 AMH 1.31 (1.22- 1.41) <0.001** 0.99 (0.87- 1.14) 0.927 Stimulation protocol GnRH agonist Reference GnRH antagonist 1.05 (0.77- 1.43) 0.769 Total FSH dose 0.77 (0.67- 0.89) <0.001** 0.68 (0.53- 0.88) 0.003** Total LH dose 0.58 (0.50- 0.67) <0.001** 1.04 (0.76- 1.44) 0.795 Fertilization method IVF Reference ICSI 0.83 (0.63- 1.09) 0.184 Stimulation day 0.96 (0.88- 1.05) 0.380 Mature oocyte 1.18 (1.14- 1.22) <0.001** 1.03 (0.96- 1.10) 0.468 Oocyte retrieval number 1.15 (1.12- 1.18) <0.001** Fertilization rate 13.62 (7.33- 25.31) <0.001** 2.28 (0.55- 9.48) 0.257 Good embryos rate at D3 10.41 (4.96- 21.81) <0.001** 1.33 (0.36- 4.91) 0.670 D2/D3 embryo transfer rate 0.17 (0.10- 0.28) <0.001** 0.71 (0.36- 1.41) 0.325 BC rate 101.67 (47.21- 218.94) <0.001** 30.04 (9.93- 90.90) <0.001** Group Control Reference endometriosis 1.16 (0.78- 1.73) 0.465 endometrioma 0.74 (0.47- 1.16) 0.186 Table 3: Baseline characteristics and results of the second analysis D. Primary Endometrioma (n=70) E. s/p Cystectomy (n=40) F. Recurrent endometrioma (n=19) D vs. E P value D vs. F P value E vs. F P value Female age (mean ± SD) 34.6 3.6 32.8 3.4 33.42.8 0.007* 0.057 0.744 BMI (kg/m2) 21 2.6 20.7 2.1 22.4 4 0.598 0.196 0.164 AMH (ng/ml) 3.2 2.5 3.4 2.8 2.7 2.5 0.828 0.277 0.239 Stimulation protocol: Agonist protocol 22/70 (31.4%) 8/40 (20.0%) 4/19 (21.1%) 0.195 0.378 0.925 Antagonist protocol 48/70 (68.6%) 32/40(80.0%) 15/19 (787.9%) Fertilization method ICSI 26/70 (37.1%) 10/40 (25%) 4/19 (21.1%) 0.192 0.188 0.793 IVF 44/70 (62.9%) 30/40 (75%) 15/19 (78.9%) Total FSH dose (IU) 3561.91211.4 2844.01109.2 3820.81277.3 0.001* 0.47 0.004* Total LH dose (IU) 1207.5718.8 915 642.8 1286.8747.6 0.03* 0.722 0.090 Stimulation days 10.5 2.4 9.3 1.5 9.8 1.7 0.012* 0.33 0.421 EMT (mm) on trigger day 11.93.6 11.2 2.6 12 2.7 0.091 0.798 0.303 No. of follicle > 14mm on trigger day 8.0 4.8 7.5 4.5 5.9 4.9 0.575 0.045* 0.154 E2 on trigger day (pg/ml) 27712146.4 2677.81831.5 1976.52110.4 0.744 0.298 0.043* P4 on trigger day (ng/ml) 1.0 0.7 0.8 0.4 0.9 0.4 0.4 0.814 0.709 No. of oocyte retrieval 10.6 6.6 11 8.5 8.9 7.4 0.592 0.191 0.342 No. of mature oocyte 8.3 5.7 8.66.6 6.76.3 0.753 0.112 0.272 Fertilization rate 73.4% 78.2% 73% 0.64 0.155 0.286 Good embryos rate on D3 31.2% 35% 32.4% 0.268 0.823 0.630 BC formation rate 49.7% 61.5% 47.8% 0.004* 0.690 0.042* D2/D3 embryo transfer rate 69.4% 69.6% 77.8% 1.00 1.00 1.00 * With statistical significance Cite Share Download PDF Status: Published Journal Publication published 17 Apr, 2023 Read the published version in Archives of Gynecology and Obstetrics → Version 1 posted Reviewers agreed at journal 22 Dec, 2022 Reviewers invited by journal 20 Dec, 2022 Editor invited by journal 14 Dec, 2022 Editor assigned by journal 10 Dec, 2022 First submitted to journal 30 Nov, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2329900","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":161518770,"identity":"fab05a5d-d505-41b6-93c2-05073cc0cfb0","order_by":0,"name":"Jui-Chun Chang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzElEQVRIiWNgGAWjYHCCBCA8wMDA3gBkG1iQooXnAEiLBNE2AZVLJIAYRGgxb2B4JvGg5k7idsnnVzf8KJBg4G/vTsCrReYAQ5pEwrFniTtn55Td7AE6TOLM2Q14tQAdkiaR2HA4ccPtnLQbPEAtBhK5xGq5eSbt5h/StNxgP3abOFuYGZItEo4dNt5wJofttoyBBA9hv7D3JN78UXNYdsPx489uvvljI8ff3otfCwMzTwKUxWMAJvErBwP2AzDGAyJUj4JRMApGwUgEANctSevweO63AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0003-1479-7156","institution":"Taichung Veterans General Hospital","correspondingAuthor":true,"prefix":"","firstName":"Jui-Chun","middleName":"","lastName":"Chang","suffix":""},{"id":161518771,"identity":"92cee96f-3065-4544-9181-8009fcbce373","order_by":1,"name":"Yu-Chiao Yi","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yu-Chiao","middleName":"","lastName":"Yi","suffix":""},{"id":161518772,"identity":"7e8a2d69-e03c-4f97-8ee7-a38061483e37","order_by":2,"name":"Ya-Fang Chen","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ya-Fang","middleName":"","lastName":"Chen","suffix":""},{"id":161518773,"identity":"73db9b17-ee50-48bb-9bc5-0745e3a41303","order_by":3,"name":"Hwa-Fen Guu","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hwa-Fen","middleName":"","lastName":"Guu","suffix":""},{"id":161518774,"identity":"063ea6ca-c91c-47b0-ae06-423b63dada07","order_by":4,"name":"Hsiao-Fan Kung","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hsiao-Fan","middleName":"","lastName":"Kung","suffix":""},{"id":161518775,"identity":"0fa0fafc-06e1-44cc-aa24-ed2f0616a8dd","order_by":5,"name":"Li-Yu Chen","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Li-Yu","middleName":"","lastName":"Chen","suffix":""},{"id":161518776,"identity":"834f4b76-f03f-47ac-b25d-6ddb0a6625b1","order_by":6,"name":"Shih-Ting Chuan","email":"","orcid":"","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shih-Ting","middleName":"","lastName":"Chuan","suffix":""},{"id":161518777,"identity":"72f4ad73-88be-413d-b864-52e2a7969b74","order_by":7,"name":"Ming-Jer Chen","email":"","orcid":"https://orcid.org/0000-0002-5618-1969","institution":"Taichung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ming-Jer","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2022-11-30 14:05:40","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2329900/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2329900/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s00404-023-07036-2","type":"published","date":"2023-04-17T20:30:48+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":30902438,"identity":"bbea8cf8-d45c-446c-a257-3fdbb8a00107","added_by":"auto","created_at":"2022-12-29 20:53:11","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":63438,"visible":true,"origin":"","legend":"\u003cp\u003eIn the patient flow chart, 208 cycles with a major indication for ART with endometriosis are shown. Eighty-nine (89)a of them are presented with endometrioma during IVF/ICSI. One-hundred-nineteen (119) of them had no endometrioma during treatment. In the cycle presented with endometrioma, 19 showed cystectomy for endometrioma previously (as the recurrent endometrioma group). The remaining of 64 did not have cystectomy previously as the primary endometrioma group. In the cycle with no endometrioma during IVF/ICSI (119), 93 were diagnosed by laparoscopy (LSC). Forty received cystectomy for endometrioma during LSC (as the s/p cystectomy group), while another 53 received only electrocauterization (EC) for peritoneal endometriosis.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2329900/v1/724440de17ae8dfa85d2ca37.png"},{"id":30902437,"identity":"4a579e6f-01f0-4628-afbb-a9a59bceaaf2","added_by":"auto","created_at":"2022-12-29 20:53:11","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":33567,"visible":true,"origin":"","legend":"\u003cp\u003eOutcome of IVF/ICSI in the endometriosis, endometrioma and control groups. There is no significant difference in terms of CPR in fresh ET cycle, LBR in fresh ET cycle, or cumulative LBR. The LBR of the first ET in freeze-all cycle is significantly higher in the control group than that in the endometrioma group.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-2329900/v1/a45b325181c82cc7b08bf5ed.png"},{"id":30902439,"identity":"93b7882b-bbd1-4229-93fc-ec5f05259907","added_by":"auto","created_at":"2022-12-29 20:53:11","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":36352,"visible":true,"origin":"","legend":"\u003cp\u003eOutcomes of IVF/ICSI in the primary endometrioma, s/p cystectomy and recurrent endometrioma groups. There is no significant difference in terms of CPR, LBR and cumulative LBR\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-2329900/v1/536b90f53c5ffb8012484604.png"},{"id":44725378,"identity":"5c1d1983-c069-4cab-9eb6-f543157683ec","added_by":"auto","created_at":"2023-10-16 20:40:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":455597,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2329900/v1/df516e10-434d-406c-b8cf-4937560c13b0.pdf"}],"financialInterests":"","formattedTitle":"Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEndometriosis is a chronic disease known to be detrimental to fertility [1]. Approximately 25\u0026ndash;50% of women experiencing infertility may be affected by endometriosis, with 30\u0026ndash;50% of women diagnosed with endometriosis being infertile [2]. A significant number of women with endometriosis eventually seek In Vitro Fertilization (IVF) with or without Intracytoplasmic Sperm Injection (ICSI) for conception. An endometrioma is the formation of a cyst within the ovary with ectopic endometrial tissue lining [3]. It is found in 17\u0026ndash;44% of patients with endometriosis [4]. The exact mechanism through which endometrioma causes infertility remains uncertain. Several proposed mechanisms include a distorting tubo-ovarian anatomy [5], reduction in the quality and quantity of developing follicles by anatomical proximity of the ovarian cyst to the nearby follicular pool [6,7], and a reduced ovarian reserve and embryo quality due to local inflammation milieu, toxic content and oxidative damage [8,9].\u003c/p\u003e\n\u003cp\u003eAlthough with a higher cancel rate and lower oocyte retrieval, current evidence shows that women with endometrioma have similar IVF/ICSI outcomes in terms of live birth rate when compared to those without endometriosis [10]. However, there have been only a few studies comparing IVF/ICSI outcomes between women with endometrioma and women with endometriosis. Current molecular, histological and morphological evidence suggests that endometrioma is detrimental to the ovaries [6,11]. The endometrioma, being different from endometriosis, likely has a specific impact on IVF/ICSI outcomes. Therefore, the first part of this study was aimed to compare IVF/ICSI outcomes between women with endometrioma and women with endometriosis.\u003c/p\u003e\n\u003cp\u003eIn the second part of our study, we aimed to determine the impact of cystectomy on IVF/ICSI outcomes. Current guidelines are unclear regarding surgical removal of an endometrioma prior to IVF/ICIS [12]. Surgical treatment of endometrioma has been shown to increase natural fecundity [13]. Additionally, an endometrioma left \u003cem\u003ein situ\u003c/em\u003e during IVF/ICSI may cause technical difficulties during oocyte retrieval, progression of the endometrioma after artificial reproductive technology (ART), and higher risks of infection [14-16]. Evidence has shown that surgical treatment on endometrioma could be detrimental to ovarian reserve [17,18], subsequently adversely affecting reproductive outcomes of IVF/ICSI [19]. Therefore, the second part of our study was aimed to determine the impact of cystectomy for endometrioma on the IVF/ICSI outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe retrospectively analyzed patients (n=2,153) who had undergone IVF/ICSI between January 2014 and December 2018, at the Center for Reproductive Medicine, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Women\u0026rsquo;s Health, Taichung Veterans General Hospital, Taichung, Taiwan. We included those cycles with the patient\u0026rsquo;s major reason for IVF/ICSI being endometriosis. Endometriosis was confirmed by laparoscopic surgery, presence of endometrioma or when pelvic examination revealed cul-de-sac nodularity with dysmenorrhea. Endometrioma was confirmed by visualizing on two or more separate examinations done at intervals which were at least one month apart, an ovarian cyst with regular margins and ground-glass echogenicity on transvaginal ultrasonography (TVUS) [20]. The endometrioma was measured along three dimensions, with the average diameter calculated during a baseline ultrasonography on D2/D3 in the month of controlled ovarian stimulation (COS). We excluded those cycles with patients aged \u0026gt; 40 years or \u0026lt;20 years, had simulation duration\u0026lt;5 days, with severe male factor (including Testicular Sperm Extraction), uterine factor (including adenomyosis asdefined by TVUS), preimplantation genetic testing for aneuploidies (PGT-A), donor eggs or immunological factors. Patients whose embryos were not completely transferred back, or who had received embryo transfer from different oocyte pick up cycles were also excluded.\u003c/p\u003e\n\u003cp\u003eThe control group included women who underwent IVF/ICSI for non-endometriosis-related infertility during the same study period. Endometriosis was ruled out in a pre-ART work-up assessment, including a clinical examination, questioning (regarding the extent of pelvic pain and a prior history of surgery) and TVUS. The control group was matched in age and Anti-mullerian Hormone (AMH) levels in 1 to 3 subject ratio. Blind matching to the results was performed. \u003c/p\u003e\n\u003cp\u003eIn the first analysis, we compared reproductive outcomes amongst patients with endometrioma present during IVF/ICSI treatment, those with only endometriosis, and the control group. In the second analysis, we compared outcomes between patients in the \u0026ldquo;Recurrent endometrioma group\u0026rdquo; who were defined as patients with endometrioma during IVF/ICSI and had a prior history of cystectomy for endometrioma. The \u0026ldquo;Primary endometrioma group\u0026rdquo; was defined as those who did not have a prior cystectomy and was with endometrioma during IVF/ICSI. Finally, the \u0026ldquo;status post (s/p) cystectomy group\u0026rdquo; was defined as patients who had received cystectomy for endometrioma prior to IVF/ICSI treatment and had shown no presence of endometrioma during IVF/ICSI. This study was approved by the Institutional Review Board of Taichung Veterans General Hospital (IRB No. CE21306B)\u003c/p\u003e\n\u003cp\u003ePatients underwent COS, oocyte retrieval and embryo transfer according to procedures as previously described [21]. Which protocol (either agonist or antagonist protocol) to use for the patient was at the discretion of the care physician. Stimulation was monitored by transvaginal ultrasound. Ovulation triggering was induced by injecting the recombinant hCG (Ovidrel, Merck Serono) and/or GnRH agonist. Ultrasound-guided transvaginal oocyte retrieval was carried out approximately 36 hours post-triggering. Oocytes were either inseminated or underwent ICSI approximately 4 hours after collection. For the fresh group, cleavage stage embryos or blastocysts were transferred. The surplus embryos were cryopreserved through vitrification. The endometrial preparations during the following frozen embryo transfer (FET) cycles were programmed by either hormone replacement cycles or modified natural cycles, depending on the individual condition of each patient. Details of the endometrium priming and luteal phase support have been reported earlier [21].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOutcomes and statistical analyses\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe followed up patients through to June 2021. Our primary outcome was cumulative live birth rate (CLBR), determined in those who had achieved through fresh and/or vitrified embryos obtained from the same oocyte retrieval cycle. Clinical pregnancy was defined as the presence of at least one embryo having cardiac activity. Live birth was defined as the delivery of a live infant after at least 24 weeks of gestation. Live birth rates (LBR) were calculated individually in the fresh ET cycle and in the first FET cycle if no fresh ET had been performed. Blastocyst formation rates only included those patients who were intended to receive blastocyst transfer.\u003c/p\u003e\n\u003cp\u003eData were presented as mean \u003cstrong\u003e\u003cu\u003e+\u003c/u\u003e\u003c/strong\u003e standard deviation (SD), or as percentage. Group comparisons were performed using Mann-Whitney and Pearson\u0026rsquo;s Chi square tests in SPSS (Version 18). Logistic regression analysis was conducted on clinical covariates assessed for their association with CLBR. Multivariable logistic regression (MLR) analysis was performed on variables that were significant at univariable analysis (P \u0026lt; 0.05). Differences were considered significant at p \u0026lt;0.05. \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eWe analyzed a\u0026nbsp;total of 208 IVF/ICSI cycles which had indications of endometriosis. These cycles consisted of 119 with endometriosis and 89 with endometrioma. The flow chart of these cycles is shown in \u003cstrong\u003eFigure 1\u003c/strong\u003e. In 89 cycles with endometrioma, 19 had received cystectomy for endometrioma prior to IVF/ICSI, and were included in the \u0026ldquo;recurrent endometrioma group\u0026rdquo;. The remaining 64 cycles were included in the \u0026ldquo;primary endometrioma group\u0026rdquo;. In 119 cycles with no endometrioma during IVF/ICSI, 40 had priorly received cystectomy for endometrioma, and were included in the \u0026ldquo;s/p cystectomy group\u0026rdquo;. After matching, we had 624 cycles without endometriosis during IVF/ICSI as the control group.\u003c/p\u003e\n\u003cp\u003eFirst analyses of the baseline characteristics and outcomes are presented in \u003cstrong\u003eTable 1\u003c/strong\u003e. Comparable characteristics in the endometriosis (A), endometrioma (B) and control (C) groups Patients in the control group had a significantly higher Body Mass Index (BMI) and received more ICSI In the endometrioma group, the mean size of endometrioma was 3.9 cm (range 1 to 9 cm).\u003c/p\u003e\n\u003cp\u003eThe gonadotropin dose given was significantly higher in the endometrioma group compared with the other groups (FSH dosage 3047 1037.9 IU versus 3619IU 1223 versus 31301065.5 IU, p=0.001 in A versus B, p= 0.4 in A versus C, p= 0.001 in B versus C; LH dosage 941 573.9 IU versus 1224721.5 IU versus 963601.2 IU, p=0.009 in A versus B, p= 0.823 in A versus C, p= 0.003 in B versus C). The number of follicles\u003cu\u003e\u0026gt;\u003c/u\u003e14 mm on the day of triggering, number of oocytes retrieved, and number of mature oocytes were lower in the endometrioma group than the control group. The blastocyst formation rate was significantly lower in the endometrioma group when compared with the other two groups (57.7% versus 49.4% versus 56%, p=0.005 in A versus B, p=0.376 in A versus C, p=0.008 in B versus C).\u003c/p\u003e\n\u003cp\u003eClinical pregnancy rate (CPR) in fresh ET, LBR in fresh ET, and CLBR were comparable in the three groups. LBR in the first FET in freeze-all cycle was significantly lower in the endometrioma group when compared with the control group (53.8% versus 36.8% versus 59.2%, p=0.134 in A versus B, p= 0.536 in A versus C, p=0.011 in B versus C) (Figure 2).\u003c/p\u003e\n\u003cp\u003eResults of MLR analyses in predicting CLBR are presented in Table 3. Female age, total FSH dosage and blastocyst formation rates were found to be significant variables in predicting CLBR (OR: 0.89, CI: 0.80\u0026ndash;0.99, p \u0026lt; 0.025; OR:0.68 CI:0.53-0.88, p=0.003 and OR: 30.04, CI: 9.93\u0026ndash;90.9, p \u0026lt; 0.001, respectively).\u003c/p\u003e\n\u003cp\u003eIn the second analysis, the baseline characteristics and clinical outcomes of primary endometrioma (D), s/p cystectomy (E) and recurrent endometrioma (F) are shown in Table 3. The female age was lower in the s/p cystectomy group than the endometrioma group (34.6 3.6 versus 32.8 \u0026nbsp; 3.4, p=0.007). Serum AMH, BMI, stimulation protocol and fertilization method were similar in each group.\u003c/p\u003e\n\u003cp\u003eTotal gonadotropin dose and length of COS were lower in the s/p cystectomy group (FHS dose 3561.9 1211.4 IU versus 2844 IU1109.2 versus 3820.81277.3 IU in group D, E, F, p=0.001 in D versus E, p=0.47 in D versus F, p= 0.004 in E versus F; LH dose 1207.5718.8 versus 915 642.8 versus 1286.8747.6, p=0.03 in D versus E, p=0.722 in D versus F, p= 0.09 in E versus F; length of stimulation 10.5 2.4 versus 9.3 1.5 versus 9.8 1.7, p=0.012 in D versus E, p=0.33 in D versus F, p= 0.421 in E versus F). The number of follicles measuring \u003cu\u003e\u0026gt;\u003c/u\u003e14 mm on the day of triggering as well as estradiol levels were lower in the recurrent endometrioma group. The blastocyst formation rate was highest in the s/p cystectomy group (49.7% versus 61.5% versus 47.8%, p= 0.004 in D versus E, p=0.69 in D versus F, p= 0.042 in E versus F).\u003c/p\u003e\n\u003cp\u003eCPR in fresh ET, LBR in fresh ET, LBR in first FTE in freeze-all cycle and CLBR were all similar in the primary endometrioma, s/p cystectomy and recurrent endometrioma groups (Figure 3).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur results show that in patients with endometriosis being the major indication for IVF/ICSI, the CLBRs were similar to the controls (non-endometriosis). Although the presence of endometrioma had comparable CLRBs, the prescribed gonadotropin dose was significantly higher, with the blastocyst formation rate being significantly lower when compared with those patients with only endometriosis. In the second analysis, CLBRs were comparable across the primary endometrioma, s/p cystectomy and recurrent endometrioma groups. The blastocyst formation rate was significantly higher in the s/p cystectomy group when compared with the other two groups.\u003c/p\u003e\n\u003cp\u003eA number of studies have investigated the effects of endometriosis on ART outcomes. In general, women with endometriosis have similar ART outcomes to those of controls in terms of LBR [22-24]. Our results are compatible with these. Regarding the relationship between the presence of endometrioma and ART outcomes, our findings are less consistent. A recent systematic review found that women with endometrioma have fewer oocytes and MII oocytes retrieved when compared to those without endometriosis, but no such differences in CPR, IR or LBR [25]. Our results are similar to theirs, showing that endometrioma was associated with higher gonadotropin consumption, a lower number of oocytes retrieved, and lower blastocyst formation rate, when compared with controls. The final outcome, CLBR, was the same as the control group. \u003c/p\u003e\n\u003cp\u003eWhen comparing patients with endometrioma and endometriosis, our results revealed the similarities of LBR and CLBR in patients with either endometrioma or endometriosis. These findings are consistent with previous studies which have shown a similarity in delivery rates and pregnancy rates in patients with unoperated endometrioma and with only endometriosis [26.27]. These studies were however conducted in the 2000s, and CLBR was not analyzed at the time.\u003c/p\u003e\n\u003cp\u003eIn comparing primary endometrioma and cystectomy prior to IVF/ICSI, we found that although the patients in the s/p cystectomy group were younger in age, their ovarian reserves were similar, likely due to the surgical excision of endometrioma having lowered the ovarian reserve [17]. In our center, it is our policy is to choose younger patients with moderate ovarian reserves as candidates for receiving cystectomy for endometrioma due to fertility reasons. We encourage these patients to undergo IVF/ICSI if they have not gotten pregnant after a one-year trial post-surgery Despite concerns surrounding a reduced ovarian reserve, surgical removal of endometrioma may improve chances of spontaneous pregnancy through restoration of the ovarian functional anatomy. This approach has been considered to be a primary treatment method for infertility patients in the case of endometrioma [12]. Additionally, such an operation also improves pain symptoms [28]. Regarding the impact of excised endometrioma on ART outcomes, we found similarities between the primary endometrioma and s/p cystectomy groups in terms of the number of oocytes retrieved, number of mature oocytes, LBR and CLBR. Our findings are consistent with most reports published in the available literature, including a recent meta-analysis [29]. Other studies have reported different results showing that endometrioma surgery diminished ovarian reserves, leading to lower pregnancy rates after IVF [30.31]. However, these studies were conducted on limited numbers of patients, with differences in surgical procedures and varying surgeon expertise. Our results regarding CLBR per oocyte retrieval further confirm that with comparable ovarian reserves, cystectomy prior to operation produced similar IVF/ICSI outcomes when compared with endometrioma\u003cem\u003e in situ\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eIn comparing primary and recurrent endometriomas, our results show weaker ovarian responses to COS in the recurrent endometrioma group. This finding is inconsistent with a previous study which reported that patients with recurrent endometriomas have the same ovarian response [32]. In contrast, the outcomes of IVF/ICSI, including LBR and CLBR in our study, were compatible between these two groups, and was consistent with that previous study [32]. There was a study showing that histologically confirmed surgery for recurrent endometrioma is associated with a greater loss of ovarian tissue, which is more harmful to ovarian reserves when compared with endometriomas which were operated on for the first time [33]. \u003cem\u003ePark et al\u003c/em\u003e., also reported that second-line surgery for recurrent endometrioma has a deleterious effect on IVF outcomes, including ovarian response and CPR, when compared with \u003cem\u003ein situ \u003c/em\u003erecurrent endometrioma [34]. It has also been reported that spontaneous cumulative pregnancy rates drop to almost half after second-line surgery for endometrioma when compared with those obtained after primary surgery [35]. Therefore, a conservative management plan to treatment for recurrent endometrioma is more suitable for women who seek fertility. \u003c/p\u003e\n\u003cp\u003eOur study has shown presence of endometrioma is associated with fewer blastocyst formations, when compared with the endometriosis or the control group. Such effects seemed to disappear after performing cystectomy on endometrioma. The poorer ovarian response and lower blastocyst formation rates were unlikely consequences of the deleterious effects which surgery had on the endometriomas, and were more likely due to endometrioma \u003cem\u003eper se\u003c/em\u003e. There are growing studies which have shown that ovarian quality may be deteriorated by endometrioma [36]. One recent study which used scRNA-seq compared oocytes from patients with endometrioma and healthy oocytes. The results revealed a differential transcriptomic profile indicating a lower oocyte quality in endometrioma [37]. These mechanisms may explain how the blastocyst formation rate we found was lower in the endometrioma group.\u003c/p\u003e\n\u003cp\u003eOur study possesses certain strengths. First, our primary outcome is CLBR per oocyte retrieval which has been seldom mentioned in previous studies and is a better indicator of quality and success in IVF/ICSI, as cryopreservation is an integral part of IVF [38]. Second, all our patients had undergone ovarian stimulation and IVF performed at a single medical center. In this regard, all measurements (AMH and TVUS) were performed consistently. Third, we compared the presence of endometrioma with endometriosis. This issue is not commonly addressed, but still has practical implications. Our results show that for the first time, the presence of endometrioma negatively influenced ovarian responsiveness and blastocyst formation rates. The main limitation of this work are its retrospective design nature and the number size of the recurrent endometrioma group being small(n=19). In addition, the endometriosis group was heterogeneous, including patients with peritoneal endometriosis or DIE, with some of them having no pathological diagnosis. Nevertheless, it is currently well accepted that TVUS is a highly accurate and reproducible method for non-invasive diagnosis of DIE and ovarian lesions [39]. Another limitation is that we did not stratify patients according to their endometriosis stages, and only stratified those with endometrioma or endometriosis. As an increasing number of patients are receiving conservative treatment prior to IVF/ICSI, the presence or absence of endometrioma is a more useful characteristic in daily practice. \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eWe have shown that IVF/ICSI outcomes are comparable in those with endometrioma and controls. Although the blastocyst formation rate was lower and gonadotropin consumption was higher in those with endometrioma, IVF/ICSI outcomes in patients with endometrioma were no worse than those with endometriosis. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if the ovarian reserve was comparable. Recurrent endometrioma did not contribute to worse impacts on the IVF/ICSI outcomes when compared with primary endometrioma.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e: Institutional Review Board, TCVGH, No. CE21306B Date of approval: August 30, 2021\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cstrong\u003e: \u0026nbsp;\u003c/strong\u003eNo funding was received for conducting this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u0026nbsp;\u003c/strong\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll data generated and analyzed during this study are included in this published article and its supplementary information files.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish\u003c/strong\u003e: Authors are responsible for correctness of the statements provided in the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJui-Chun Chang and\u0026nbsp;: Protocol/project development, Data Collection, Manuscript writing\u003c/p\u003e\n\u003cp\u003eMing-Jer Chen: Protocol/project development\u003c/p\u003e\n\u003cp\u003eHsiao-Fan Kung: prepared the figures and tables\u003c/p\u003e\n\u003cp\u003eYu-Chiao Yi: prepared the figures and tables.\u003c/p\u003e\n\u003cp\u003eHwa-Fen Guu :Data collection or management\u003c/p\u003e\n\u003cp\u003eLi-Yu Chen: Data collection or management\u003c/p\u003e\n\u003cp\u003eYa-Fang Chen: Data analysis\u003c/p\u003e\n\u003cp\u003eShih-Ting Chuan : Data analysis \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;All authors reviewed the manuscript.\u0026quot;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHoloch, K. J. and B. A. Lessey. \u0026quot;Endometriosis and infertility.\u0026quot; Clin Obstet Gynecol2010 53: 429-438.\u003c/li\u003e\n\u003cli\u003eMacer, M. L. and H. S. Taylor. \u0026quot;Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility.\u0026quot; Obstet Gynecol Clin North Am 2012;39: 535-549.\u003c/li\u003e\n\u003cli\u003eHughesdon, P. E. \u0026quot;The structure of endometrial cysts of the ovary.\u0026quot; J Obstet Gynaecol Br Emp 1957;64: 481-487.\u003c/li\u003e\n\u003cli\u003eAlborzi, S., P. Keramati, M. Younesi, A. Samsami and N. Dadras (). \u0026quot;The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas.\u0026quot; Fertil Steril 2014;101(2): 427-434\u003c/li\u003e\n\u003cli\u003eYoung, V. J., J. K. Brown, P. T. Saunders and A. W. Horne. \u0026quot;The role of the peritoneum in the pathogenesis of endometriosis.\u0026quot; Hum Reprod Update2013;19: 558-569.\u003c/li\u003e\n\u003cli\u003eSanchez, A. M., P. Vigan\u0026ograve;, E. Somigliana, P. Panina-Bordignon, P. Vercellini and M. Candiani. \u0026quot;The distinguishing cellular and molecular features of the endometriotic ovarian cyst: from pathophysiology to the potential endometrioma-mediated damage to the ovary.\u0026quot; Hum Reprod Update 2014;20: 217-230.\u003c/li\u003e\n\u003cli\u003eKuroda, M., K. Kuroda, A. Arakawa, Y. Fukumura, M. Kitade, I. Kikuchi, J. Kumakiri, S. Matsuoka, I. A. Brosens, J. J. Brosens, S. Takeda and T. Yao. \u0026quot;Histological assessment of impact of ovarian endometrioma and laparoscopic cystectomy on ovarian reserve.\u0026quot; J Obstet Gynaecol Res 2012;38: 1187-1193\u003c/li\u003e\n\u003cli\u003eMatsuzaki, S. and B. Schubert. \u0026quot;Oxidative stress status in normal ovarian cortex surrounding ovarian endometriosis.\u0026quot; Fertil Steril 2010;93: 2431-2432.\u003c/li\u003e\n\u003cli\u003eMuzii, L., C. Di Tucci, M. Di Feliciantonio, G. Galati, V. Di Donato, A. Musella, I. Palaia and P. B. Panici. \u0026quot;Antim\u0026uuml;llerian hormone is reduced in the presence of ovarian endometriomas: a systematic review and meta-analysis.\u0026quot; Fertil Steril 2018;110: 932-940.\u003c/li\u003e\n\u003cli\u003eHamdan, M., G. Dunselman, T. C. Li and Y. Cheong. \u0026quot;The impact of endometrioma on IVF/ICSI outcomes: a systematic review and meta-analysis.\u0026quot; Hum Reprod Update 2015;21: 809-825.\u003c/li\u003e\n\u003cli\u003eSanchez, A. M., V. S. Vanni, L. Bartiromo, E. Papaleo, E. Zilberberg, M. Candiani, R. Orvieto and P. Vigan\u0026ograve;. \u0026quot;Is the oocyte quality affected by endometriosis? A review of the literature.\u0026quot; J Ovarian Res2017; 10: 43.\u003c/li\u003e\n\u003cli\u003eBecker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, King K, Kvaskoff M, Nap A, Petersen K, Saridogan E, Tomassetti C, van Hanegem N, Vulliemoz N, Vermeulen N; ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod Open. 2022 Feb 26;2022(2):hoac009.\u003c/li\u003e\n\u003cli\u003eVercellini, P., E. Somigliana, R. Daguati, G. Barbara, A. Abbiati and L. Fedele. \u0026quot;The second time around: reproductive performance after repetitive versus primary surgery for endometriosis.\u0026quot; Fertil Steril 2009;92: 1253-1255.\u003c/li\u003e\n\u003cli\u003eBenaglia, L., E. Somigliana, R. Iemmello, E. Colpi, A. E. Nicolosi and G. Ragni. \u0026quot;Endometrioma and oocyte retrieval-induced pelvic abscess: a clinical concern or an exceptional complication?\u0026quot; Fertil Steril 2008;89: 1263-1266.\u003c/li\u003e\n\u003cli\u003eNieweglowska, D., I. Hajdyla-Banas, K. Pitynski, T. Banas, O. Grabowska, G. Juszczyk, A. Ludwin and R. Jach. \u0026quot;Age-related trends in anti-Mullerian hormone serum level in women with unilateral and bilateral ovarian endometriomas prior to surgery.\u0026quot; Reprod Biol Endocrinol 2015;13: 128.\u003c/li\u003e\n\u003cli\u003eSomigliana, E., L. Benaglia, A. Paffoni, A. Busnelli, P. Vigano and P. Vercellini. \u0026quot;Risks of conservative management in women with ovarian endometriomas undergoing IVF.\u0026quot; Hum Reprod Update 2015;21: 486-499.\u003c/li\u003e\n\u003cli\u003eYounis, J. S., N. Shapso, R. Fleming, I. Ben-Shlomo and I. Izhaki \u0026quot;Impact of unilateral versus bilateral ovarian endometriotic cystectomy on ovarian reserve: a systematic review and meta-analysis.\u0026quot; Hum Reprod Update2019; 25: 375-391.\u003c/li\u003e\n\u003cli\u003eErgun, B., M. Ozsurmeli, O. Dundar, C. Comba, O. Kuru and S. Bodur. \u0026quot;Changes in Markers of Ovarian Reserve After Laparoscopic Ovarian Cystectomy.\u0026quot; J Minim Invasive Gynecol 2015;22: 997-1003.\u003c/li\u003e\n\u003cli\u003eBenschop, L., C. Farquhar, N. van der Poel and M. J. Heineman. \u0026quot;Interventions for women with endometrioma prior to assisted reproductive technology.\u0026quot; Cochrane Database Syst Rev2010 (11): Cd008571.\u003c/li\u003e\n\u003cli\u003eExacoustos, C., L. Manganaro and E. Zupi. \u0026quot;Imaging for the evaluation of endometriosis and adenomyosis.\u0026quot; Best Pract Res Clin Obstet Gynaecol 2014;28: 655-681\u003c/li\u003e\n\u003cli\u003eJui-Chun Chang , Ming-Jer Chen, Hwa-Fen Guu , Ya-Fang Chen , Yu-Chiao Yi, Hsiao-Fan Kung, Li-Yu Chen, Min-Min Chou Does the \u0026ldquo;freeze-all\u0026rdquo; policy allow for a better outcome in assisted reproductive techniques than the use of fresh embryo transfers? A retrospective study\u003c/li\u003e\n\u003cli\u003eSenapati, S., M. D. Sammel, C. Morse and K. T. Barnhart. \u0026quot;Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database.\u0026quot; Fertil Steril 2016;106: 164-171\u003c/li\u003e\n\u003cli\u003ePrefumo, F. and A. C. Rossi \u0026quot;Endometriosis, endometrioma, and ART results: Current understanding and recommended practices.\u0026quot; Best Pract Res Clin Obstet Gynaecol 2018; 51: 34-40.\u003c/li\u003e\n\u003cli\u003eRossi, A. C. and F. Prefumo. \u0026quot;The effects of surgery for endometriosis on pregnancy outcomes following in vitro fertilization and embryo transfer: a systematic review and meta-analysis.\u0026quot; Arch Gynecol Obstet 2016;294: 647-655.\u003c/li\u003e\n\u003cli\u003eAlshehre SM, Narice BF, Fenwick MA, Metwally M. The impact of endometrioma on in vitro fertilisation/intra-cytoplasmic injection IVF/ICSI reproductive outcomes: a systematic review and meta-analysis. Arch Gynecol Obstet. 2021 Jan;303(1):3-16.\u003c/li\u003e\n\u003cli\u003eKuroda, K., M. Kitade, I. Kikuchi, J. Kumakiri, S. Matsuoka, M. Kuroda and S. Takeda. \u0026quot;The impact of endometriosis, endometrioma and ovarian cystectomy on assisted reproductive technology.\u0026quot; Reprod Med Biol 2009;8: 113-118.\u003c/li\u003e\n\u003cli\u003eSuzuki, T., S. Izumi, H. Matsubayashi, H. Awaji, K. Yoshikata and T. Makino. \u0026quot;Impact of ovarian endometrioma on oocytes and pregnancy outcome in in vitro fertilization.\u0026quot; Fertil Steril 2005;83: 908-913.\u003c/li\u003e\n\u003cli\u003eLeonardi, M., T. Gibbons, M. Armour, R. Wang, E. Glanville, R. Hodgson, A. E. Cave, J. Ong, Y. Y. F. Tong, T. Z. Jacobson, B. W. Mol, N. P. Johnson and G. Condous \u0026quot;When to Do Surgery and When Not to Do Surgery for Endometriosis: A Systematic Review and Meta-analysis.\u0026quot; J Minim Invasive Gynecol 2020;27: 390-407.\u003c/li\u003e\n\u003cli\u003eWu, C. Q., A. Albert, S. Alfaraj, O. Taskin, G. M. Alkusayer, J. Havelock, P. Yong, C. Allaire and M. A. Bedaiwy \u0026quot;Live Birth Rate after Surgical and Expectant Management of Endometriomas after In Vitro Fertilization: A Systematic Review, Meta-Analysis, and Critical Appraisal of Current Guidelines and Previous Meta-Analyses.\u0026quot; J Minim Invasive Gynecol 2019 26: 299-311.\u003c/li\u003e\n\u003cli\u003eMaignien, C., P. Santulli, V. Gayet, M. C. Lafay-Pillet, D. Korb, M. Bourdon, L. Marcellin, D. de Ziegler and C. Chapron \u0026quot;Prognostic factors for assisted reproductive technology in women with endometriosis-related infertility.\u0026quot; Am J Obstet Gynecol 2017;216: 280.e1-280.e9\u003c/li\u003e\n\u003cli\u003eRoustan, A., J. Perrin, M. Debals-Gonthier, O. Paulmyer-Lacroix, A. Agostini and B. Courbiere \u0026quot;Surgical diminished ovarian reserve after endometrioma cystectomy versus idiopathic DOR: comparison of in vitro fertilization outcome.\u0026quot; Hum Reprod 2015;30: 840-847.\u003c/li\u003e\n\u003cli\u003eAta, B., S. Mumusoglu, K. Aslan, A. Seyhan, I. Kasapoglu, B. Avci, B. Urman, G. Bozdag and G. Uncu \u0026quot;Which is worse? Comparison of ART outcome between women with primary or recurrent endometriomas.\u0026quot; Hum Reprod 2017;32:1427-1431.\u003c/li\u003e\n\u003cli\u003eMuzii, L., C. Achilli, F. Lecce, A. Bianchi, S. Franceschetti, C. Marchetti, G. Perniola and P. B. Panici. \u0026quot;Second surgery for recurrent endometriomas is more harmful to healthy ovarian tissue and ovarian reserve than first surgery.\u0026quot; Fertil Steril 2015;103: 738-743.\u003c/li\u003e\n\u003cli\u003ePark, H., C. H. Kim, E. Y. Kim, J. W. Moon, S. H. Kim, H. D. Chae and B. M. Kang. \u0026quot;Effect of second-line surgery on in vitro fertilization outcome in infertile women with ovarian endometrioma recurrence after primary conservative surgery for moderate to severe endometriosis.\u0026quot; Obstet Gynecol Sci 2015;58: 481-486.\u003c/li\u003e\n\u003cli\u003eVercellini, P., E. Somigliana, P. Vigan\u0026ograve;, A. Abbiati, G. Barbara and P. G. Crosignani. \u0026quot;Surgery for endometriosis-associated infertility: a pragmatic approach.\u0026quot; Hum Reprod 2009;24: 254-269\u003c/li\u003e\n\u003cli\u003eCorach\u0026aacute;n A, Pellicer N, Pellicer A, Ferrero H. Novel therapeutic targets to improve IVF outcomes in endometriosis patients: a review and future prospects. Hum Reprod Update. 2021;27:923-972.\u003c/li\u003e\n\u003cli\u003eFerrero H, Corachan A, Aguilar A, Qui~nonero A, Carbajo-Garcia MC, Alama P, Tejera A, Taboas E, Munoz E, Pellicer A. Single-cell RNA sequencing of oocytes from ovarian endometriosis patients reveals a differential transcriptomic profile associated with lower quality. Hum Reprod 2019;34:1302\u0026ndash;1312\u003c/li\u003e\n\u003cli\u003eGarrido, N., J. Bellver, J. Remoh\u0026iacute;, C. Sim\u0026oacute;n and A. Pellicer. \u0026quot;Cumulative live-birth rates per total number of embryos needed to reach newborn in consecutive in vitro fertilization (IVF) cycles: a new approach to measuring the likelihood of IVF success.\u0026quot; Fertil Steril 2011;96: 40-46.\u003c/li\u003e\n\u003cli\u003eExacoustos, C., E. Zupi and E. Piccione. \u0026quot;Ultrasound Imaging for Ovarian and Deep Infiltrating Endometriosis.\u0026quot; Semin Reprod Med 2017;35: 5-24\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Baseline characteristics and results of the first analysi \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"margin-right: calc(16%); width: 84%;\" width=\"690\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e. \u003cstrong\u003eEndometriosis (n=119)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e.\u003cstrong\u003e\u0026nbsp;E\u003c/strong\u003e\u003cstrong\u003endometrioma (n=89)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e\u003cstrong\u003eC. Control\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=624)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u003cstrong\u003eA vs. B\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003eA vs. C\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003eB vs. C\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" width=\"0.7256894049346879%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eFemale age (y; mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e34.1\u0026nbsp;3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e34.4 \u0026nbsp; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e34.3 \u0026nbsp;3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.884\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.82608695652174%\"\u003e\n \u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.82608695652174%\"\u003e\n \u003cp\u003e20.9 \u0026nbsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.82608695652174%\"\u003e\n \u003cp\u003e21.3 \u0026nbsp;3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.072463768115941%\"\u003e\n \u003cp\u003e22.3 \u0026nbsp;3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.289855072463768%\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.144927536231885%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"11.014492753623188%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.019*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eAMH (ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e3.6 \u0026nbsp; 2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e3.1 \u0026nbsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e3.5 \u0026nbsp;3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.449\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eStimulation protocol:\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eAgonist protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e33/119 (27.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e26/89 (29.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e158/624 (25.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.814\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.432\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eAntagonist protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e86/119 (72.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e63/89 (70.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e466/624 (74.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eFertilization method:\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e33/199 (27.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e30/89(33.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e291/624 (46.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.353\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e86/199(72.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e59/89(66.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e333/624 (53.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eTotal FSH dosage (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e3047.31037.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e3619.41223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e31301065.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eTotal LH dosage (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e941.0 \u0026nbsp;573.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e1224.4721.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e963601.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eStimulation days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e9.9 \u0026nbsp;1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e10.3 \u0026nbsp;2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e10.1\u0026nbsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.326\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.912\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eEMT\u0026nbsp;(mm), trigger day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e11.2 \u0026nbsp; 2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e11.9 \u0026nbsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e11.0\u0026nbsp;3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.028*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.699\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eTotal\u003cu\u003e\u0026gt;\u003c/u\u003e 14mm follicle number\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e8.5 \u0026nbsp;4.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e7.6 \u0026nbsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e9.1 \u0026nbsp;5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.028*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eE2 on trigger day (pg/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e2779.31753.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e2602.1\u0026nbsp;2151.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e2799.61993.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.172\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eP4 on trigger day (ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e0.9 \u0026nbsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e1.0 \u0026nbsp; 0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e1.0 \u0026nbsp;0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.801\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.668\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eNumber of oocyte retrieval\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e12.4 \u0026nbsp;8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e10.3 \u0026nbsp; 6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e12.7 \u0026nbsp;8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.624\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.017*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eNumber of mature oocytes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e9.6 \u0026nbsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e8.0 \u0026nbsp; 5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e10.0\u0026nbsp;7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.552\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.013*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eFertilization rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e74.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e69.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eGood embryos rate at D3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e32.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e31.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e34.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eBC formation rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e57.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e49.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e56%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.038%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003eD2/D3 embryo transfer rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 18.489%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e58.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17.8877%;\" valign=\"top\" width=\"17.851959361393323%\"\u003e\n \u003cp\u003e71.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.182%;\" valign=\"top\" width=\"15.09433962264151%\"\u003e\n \u003cp\u003e69.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.304789550072568%\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.2216%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9.9209%;\" valign=\"top\" width=\"10.159651669085632%\"\u003e\n \u003cp\u003e0.783\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eBMI, body mass index; AMH, anti-M\u0026uuml;llerian hormone; FSH, follicle-stimulating hormone; LH: luteinizing hormone; EMT: endometrial thickness; BC: blastocyst; E2, estradiol; P, progesterone.\u003c/p\u003e\n\u003cp\u003e*With statistical significance\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2 Univariate and multivariate analysis of factors affecting the CLBR in patients undergoing IVF/ICSI.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"719\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 18.3673%;\" width=\"22.39221140472879%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 39.3586%;\" width=\"40.75104311543811%\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 29.8626%;\" width=\"36.30041724617524%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"15.232974910394265%\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 15.1187%;\" width=\"22.939068100358423%\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"14.336917562724015%\"\u003e\n \u003cp\u003e\u003cem\u003ep\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"10.75268817204301%\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 13.3694%;\" width=\"20.60931899641577%\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"15.412186379928315%\"\u003e\n \u003cp\u003e\u003cem\u003ep\u0026nbsp;\u003c/em\u003evalue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eAge, years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.87\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.83-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e0.89\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.80-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.025*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eBMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.00\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(1.00-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.720\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eAMH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.31\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(1.22-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e0.99\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.87-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.927\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 30.8621%;\" width=\"34.30962343096234%\"\u003e\n \u003cp\u003eStimulation protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eGnRH agonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eGnRH antagonist\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.05\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.77-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.769\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eTotal FSH dose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.77\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.67-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e0.68\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.53-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e0.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.003**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eTotal LH dose\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.58\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.50-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e1.04\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.76-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e1.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.795\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 30.8621%;\" width=\"34.30962343096234%\"\u003e\n \u003cp\u003eFertilization method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eIVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.83\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.63-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.184\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eStimulation day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.96\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.88-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.380\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eMature oocyte\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.18\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(1.14-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e1.03\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.96-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.468\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eOocyte retrieval number\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.15\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(1.12-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eFertilization rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e13.62\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(7.33-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e25.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e2.28\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.55-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e9.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.257\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eGood embryos rate at D3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e10.41\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(4.96-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e21.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e1.33\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.36-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e4.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.670\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eD2/D3 embryo transfer rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.17\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.10-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e0.71\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(0.36-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e1.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e0.325\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eBC rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e101.67\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(47.21-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e218.94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e30.04\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e(9.93-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e90.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e\u0026lt;0.001**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eendometriosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e1.16\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.78-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.465\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 18.3673%;\" width=\"22.454672245467226%\"\u003e\n \u003cp\u003eendometrioma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12.4948%;\" width=\"11.854951185495118%\"\u003e\n \u003cp\u003e0.74\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.647140864714087%\"\u003e\n \u003cp\u003e(0.47-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"9.06555090655509%\"\u003e\n \u003cp\u003e1.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11.7451%;\" width=\"11.157601115760112%\"\u003e\n \u003cp\u003e0.186\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8.7464%;\" width=\"8.368200836820083%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.3719%;\" width=\"8.92608089260809%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5.9975%;\" width=\"6.97350069735007%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7.7468%;\" width=\"11.99442119944212%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3: Baseline characteristics and results of the second analysis\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"697\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e\u003cstrong\u003eD. Primary Endometrioma (n=70)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e\u003cstrong\u003eE. s/p Cystectomy (n=40)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e\u003cstrong\u003eF. Recurrent endometrioma\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(n=19)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003eD vs.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003eD vs. F\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003eE vs. F\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eFemale age (mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e34.6\u0026nbsp;3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e32.8 \u0026nbsp; 3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e33.42.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.057\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.744\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e21 \u0026nbsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e20.7 \u0026nbsp;2.1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e22.4 \u0026nbsp;4\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.598\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.196\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.164\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eAMH (ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e3.2 \u0026nbsp; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e3.4 \u0026nbsp;2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e2.7 \u0026nbsp;2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.828\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.277\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.239\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eStimulation protocol:\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003e\u0026nbsp; Agonist protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e22/70 (31.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e8/40 (20.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e4/19 (21.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.925\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003e\u0026nbsp; Antagonist protocol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e48/70 (68.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e32/40(80.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e15/19 (787.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eFertilization method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003e\u0026nbsp; ICSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e26/70 (37.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e10/40 (25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e4/19 (21.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.793\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003e\u0026nbsp; IVF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e44/70 (62.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e30/40 (75%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e15/19 (78.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eTotal FSH dose (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e3561.91211.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e2844.01109.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e3820.81277.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.47\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eTotal LH dose (IU)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e1207.5718.8\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e915 \u0026nbsp;642.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e1286.8747.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.03*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.722\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.090\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eStimulation days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e10.5\u0026nbsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e9.3 \u0026nbsp;1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e9.8 \u0026nbsp;1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.012*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.33\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.421\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eEMT (mm) on trigger day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e11.93.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e11.2 \u0026nbsp;2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e12 \u0026nbsp;2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.091\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.798\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.303\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eNo. of follicle \u003cu\u003e\u0026gt;\u003c/u\u003e 14mm on trigger day\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e8.0 \u0026nbsp;4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e7.5 \u0026nbsp;4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e5.9 \u0026nbsp;4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.575\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.045*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.154\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eE2 on trigger day (pg/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e27712146.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e2677.81831.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e1976.52110.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.744\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.298\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.043*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eP4 on trigger day (ng/ml)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e1.0 \u0026nbsp;0.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e0.8\u0026nbsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e0.9 \u0026nbsp;0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.4\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.814\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.709\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eNo. of oocyte retrieval\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e10.6 \u0026nbsp;6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e11\u0026nbsp;8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e8.9 \u0026nbsp;7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.592\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.191\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.342\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eNo. of mature oocyte\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e8.3 \u0026nbsp;5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e8.66.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e6.76.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.753\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.112\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.272\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eFertilization rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e73.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e78.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e73%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.64\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.286\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eGood embryos rate on D3\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e31.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e32.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.268\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.630\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eBC formation rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e49.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e61.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e47.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e0.690\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.042*\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"22.73381294964029%\"\u003e\n \u003cp\u003eD2/D3 embryo transfer rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.258992805755394%\"\u003e\n \u003cp\u003e69.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.971223021582734%\"\u003e\n \u003cp\u003e69.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"16.546762589928058%\"\u003e\n \u003cp\u003e77.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.496402877697841%\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;* With statistical significance\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Endometriosis, endometrioma, IVF/ICSI outcome, cystectomy, cumulative live birth rates","lastPublishedDoi":"10.21203/rs.3.rs-2329900/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2329900/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e: These study aims to assess the impact of endometrioma on patients who undergo ART treatment due to endometriosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Retrospective study was conducted in women ≤ 40 years of age who underwent ART treatment at an academic medical center between January 2014 and December 2020. Two-hundred-and-eight women had received IVF/ICSI treatment due to endometriosis and there were 89 patients’ presence of endometrioma. Patients were further divided into primary endometrioma, recurrent endometrioma and those having received cystectomy for endometrioma prior to IVF/ICSI. The control group included 624 infertile women without endometriosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: In the endometrioma subgroup (B) the blastocyst formation rate was significantly lower when compared with the endometriosis (A) and control groups (C). The cumulative live birth rates (CLBRs) (60.5% versus 49.4% versus 56.9%, p=0.194 in A versus B, p=0.406 in A versus C, p=0.878 in B versus C) were comparable. Multiple logistic regression analysis revealed that female age, total FSH dose and blastocyst formation rate were the significant variables in predicting CLBR (OR: 0.89, CI: 0.80–0.99, p \u0026lt; 0.025, OR:0.68 CI:0.53-0.88, p=0.003 and OR: 30.04, CI: 9.93–90.9, p \u0026lt; 0.001, respectively). The CLBRs were comparable 47.1%, 60% and 57.9% in the primary endometrioma, s/p cystectomy and recurrent endometrioma group\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eAlthough the blastocyst formation rate was lower in the endometrioma group, CLBR was not worse than those who were in the endometriosis or control group. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if ovarian reserve was comparable. Recurrent endometrioma did not worsen IVF/ICSI outcomes than primary endometrioma.\u003c/p\u003e","manuscriptTitle":"Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-12-29 20:53:07","doi":"10.21203/rs.3.rs-2329900/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"","date":"2022-12-22T16:12:26+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-12-20T09:10:09+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"Archives of Gynecology and Obstetrics","date":"2022-12-14T18:10:30+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-12-10T06:07:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Gynecology and Obstetrics","date":"2022-11-30T09:03:58+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-gynecology-and-obstetrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"arch","sideBox":"Learn more about [Archives of Gynecology and Obstetrics](https://www.springer.com/journal/404)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/arch/default.aspx","title":"Archives of Gynecology and Obstetrics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"873d7e34-dd3d-4ba2-8b0f-d3bbf67ed1eb","owner":[],"postedDate":"December 29th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T20:35:24+00:00","versionOfRecord":{"articleIdentity":"rs-2329900","link":"https://doi.org/10.1007/s00404-023-07036-2","journal":{"identity":"archives-of-gynecology-and-obstetrics","isVorOnly":false,"title":"Archives of Gynecology and Obstetrics"},"publishedOn":"2023-04-17 20:30:48","publishedOnDateReadable":"April 17th, 2023"},"versionCreatedAt":"2022-12-29 20:53:07","video":"","vorDoi":"10.1007/s00404-023-07036-2","vorDoiUrl":"https://doi.org/10.1007/s00404-023-07036-2","workflowStages":[]},"version":"v1","identity":"rs-2329900","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2329900","identity":"rs-2329900","version":["v1"]},"buildId":"WvIrzKhiLBfengagbw6Ux","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}