IVF Outcomes in Women with Endometriosis: A Comparative Study with Tubal Factor Infertility

Objective: Endometriosis is a complex gynaecological condition associated with infertility; however, the impact of endometriosis on assisted reproductive technology (ART) outcomes remains unclear. The objective of this study was to compare the outcomes of in vitro fertilization (IVF) between women with endometriosis and those with tubal factor infertility and to evaluate whether significant differences exist between the groups in terms of fertilization rate, embryo development, and live birth rate.Methods: The present retrospective observational study comprised 50 women diagnosed with endometriosis and 57 women with tubal factor infertility who underwent embryo transfer at a single fertility centre between 2017 and 2024. Patients with incomplete data, polycystic ovary syndrome, poor ovarian response, uterine myomas, or ovulatory factor infertility were excluded from the study. The collected variables included female and male ages, endometrial thickness, semen parameters (total sperm count and motility), total oocytes retrieved, metaphase II oocyte count, fertilization rate, embryo quality on days 2 and 3, blastocyst number, embryo transfer day, total embryos, biochemical pregnancy (hCG positivity), and live birth outcomes. The fertilization rate was calculated as the ratio of 2PN oocytes to total oocytes retrieved. Statistical analyses were performed using SPSS 20. Continuous variables were compared using Student's t-test or the Mann–Whitney U test, while categorical variables were analysed using Chi-square or Fisher's exact test. Statistical significance was defined as a p-value less than 0.05.Results: Female and male ages, endometrial thickness, and total sperm count were comparable between the groups (p>0.05). No significant differences were observed in total oocyte and mature (MII) oocyte numbers, fertilization rate, day 2 and day 3 embryo quality, blastocyst count, embryo transfer day, or total number of embryos (p>0.05). Biochemical pregnancy and live birth rates were slightly higher in women with endometriosis compared to the control group, but these differences were not statistically significant (p>0.05). Sperm motility and the incidence of asthenozoospermia were also similar between the groups (p>0.05). These findings indicate that, in women with endometriosis, appropriate laboratory conditions and protocol implementation may minimize potential factors that could adversely affect ART outcomes.Conclusion: A comparative analysis of assisted reproductive technology (ART) outcomes in women diagnosed with endometriosis and women with tubal factor infertility reveals no significant disparities in fertilisation, embryo development, and live birth rates. These findings suggest that, under well-controlled laboratory conditions and among relatively young patients, the adverse effects of endometriosis on ART success may be mitigated. Standardised protocols and judicious patient selection are imperative to optimise reproductive outcomes in this demographic. The present study demonstrates that the success of assisted reproductive technology (ART) in women with endometriosis can reach levels comparable to those with tubal factor infertility, thus providing a promising perspective for clinical practice.