Prognostic Factors of IVF&ICSI Cycle Cancellation in Patients with Endometriosis-Related Infertility

Elif Külahçı Aslan, Kiper Aslan, Cihan Çakır, Işıl Kasapoğlu, Berrin Avcı, Barış Ata, Gürkan Uncu
In: Gynecology Obstetrics & Reproductive Medicine · 2020 · pp. 1–6 · doi:10.21613/gorm.2020.1090 · W3113552458
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Poor ovarian reserve, advanced age, adenomyosis, and prior laparotomy were associated with IVF cycle cancellation in endometriosis patients, with antral follicle count being the sole independent predictor.

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This retrospective cohort study analyzed prognostic factors for intracytoplasmic sperm injection cycle cancellation among infertile patients with endometriosis who lacked male factor infertility or systemic diseases. Researchers compared cycles resulting in embryo transfer against those cancelled, identifying that higher age, elevated day 3 FSH levels, lower anti-Mullerian hormone and antral follicle counts, the presence of adenomyosis, and prior laparotomy were significantly associated with cancellation. Binary logistic regression determined that only antral follicle count served as an independent predictor for cycle cancellation, while the specific phenotype of endometriosis did not influence outcomes. This paper is centrally about endometriosis — specifically examining how different phenotypes and associated conditions like adenomyosis impact IVF success rates.

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Abstract

Objective: To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancellation in patients with endometriosis-related infertility. Study Design: This was a retrospective cohort study and conducted at the Assisted Reproductive Technology center of Uludag University School of Medicine, between the years 2011-2017. The electronic database was screened and infertile patients with endometriosis, without male factor infertility, systemic disease, or undefined adnexal mass, and aged <40 were selected. The endometriosis phenotype of all cycles was classified into three subgroups: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis. Cycles were divided into two groups: Group I (Cycle Cancellation) vs. Group II (Embryo transferred). Results: Forty-four cycles were canceled and in 178 cycles, the embryo was able to be transferred. When the groups were compared age and day 3 FSH levels were statistically higher, and anti-Mullerian hormone and antral follicle count were statistically lower in Group I. The presence of adenomyosis was higher in Group I (64% vs. 40% p<0.01). The surgery rate with laparotomy was higher in Group I (54.5% vs. 13.5% p<0.01). Antral follicle count remained as the only independent factor associated with prognoses of the IVF cycle with binary logistic regression analysis. Cancellation rates were similar between the phenotypes of endometriosis. Conclusions: Poor ovarian reserve, advanced age, presence of adenomyosis, and history of laparotomy are negative prognostic factors associated with intracytoplasmic sperm injection cycle cancellation in endometriosis-related infertility. Antral follicle count is the only independent factor in predicting cycle cancellation. The phenotype of endometriosis does not affect the results.
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Objective

To elucidate the prognostic factors for intracytoplasmic sperm injection cycle cancellation in patients with endometriosis-related infertility. Study Design: This was a retrospective cohort study and conducted at the Assisted Reproductive Technology center of Uludag University School of Medicine, between the years 2011-2017. The electronic database was screened and infertile patients with endometriosis, without male factor infertility, systemic disease, or undefined adnexal mass, and aged <40 were selected. The endometriosis phenotype of all cycles was classified into three subgroups: superficial endometriosis, ovarian endometrioma and deep infiltrating endometriosis. Cycles were divided into two groups: Group I (Cycle Cancellation) vs. Group II (Embryo transferred).

Results

Forty-four cycles were canceled and in 178 cycles, the embryo was able to be transferred. When the groups were compared age and day 3 FSH levels were statistically higher, and anti-Mullerian hormone and antral follicle count were statistically lower in Group I. The presence of adenomyosis was higher in Group I (64% vs. 40% p<0.01). The surgery rate with laparotomy was higher in Group I (54.5% vs. 13.5% p<0.01). Antral follicle count remained as the only independent factor associated with prognoses of the IVF cycle with binary logistic regression analysis. Cancellation rates were similar between the phenotypes of endometriosis.

Conclusions

Poor ovarian reserve, advanced age, presence of adenomyosis, and history of laparotomy are negative prognostic factors associated with intracytoplasmic sperm injection cycle cancellation in endometriosis-related infertility. Antral follicle count is the only independent factor in predicting cycle cancellation. The phenotype of endometriosis does not affect the results. Downloads Downloads Published How to Cite Issue Section License Copyright (c) 2020 Elif Külahci Aslan, Kiper Aslan, Cihan Cakir, Isil Kasapoglu, Berrin Avci, Baris Ata, Gurkan Uncu This work is licensed under a Creative Commons Attribution 4.0 International License. All the articles published in GORM are licensed with "Creative Commons Attribution 4.0 License (CC BY 4.0)". This license entitles all parties to copy, share and redistribute all the articles, data sets, figures and supplementary files published in this journal in data mining, search engines, web sites, blogs and other digital platforms under the condition of providing references.

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Condition tags

endometriosisadenomyosisdie_deep_infiltratingendometriomainfertility

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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