Effect of endometriosis on in vitro fertilization

Barnhart K, Kurt T. Barnhart, Kurt Barnhart, Dunsmoor-Su R, Rebecca Dunsmoor-Su, Christos Coutifaris, Coutifaris C
Fertility and Sterility · 2002 · vol. 77(6) , pp. 1148–1155 · doi:10.1016/s0015-0282(02)03112-6 · PMID:12057720 · W2048198010
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This paper investigated the impact of endometriosis on in vitro fertilization outcomes.

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Abstract

ObjectiveTo investigate the IVF outcome for patients with endometriosis.DesignMeta-analysis.SettingAcademic research center.Patient(s)A MEDLINE search and review of the literature were performed. Patients were classified by level of endometriosis, and controls were classified according to the indication for IVF.Intervention(s)Bivariate analysis and multivariate logistic regression was used to estimate overall effect and control for confounding.Main outcome measure(s)Pregnancy rates, fertilization rate, implantation rates, and numbers of oocytes retrieved.Result(s)Twenty-two published studies were included in the overall analysis. The chance of achieving pregnancy was significantly lower for endometriosis patients (odds ratio, 0.56; 95% confidence interval, 0.44-0.70) when compared with tubal factor controls. Multivariate analysis also demonstrated a decrease in fertilization and implantation rates, and a significant decrease in the number of oocytes retrieved for endometriosis patients. Pregnancy rates for women with severe endometriosis were significantly lower than for women with mild disease (odds ratio, 0.60; 95% confidence interval, 0.42-0.87).Conclusion(s)Patients with endometriosis-associated infertility undergoing IVF respond with significantly decreased levels of all markers of reproductive process, resulting in a pregnancy rate that is almost one half that of women with other indications for IVF. These data suggest that the effect of endometriosis is not exclusively on the receptivity of the endometrium but also on the development of the oocyte and embryo.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fertilization in Vitro Adult Cell Count Embryo Implantation Endometriosis Female Fertilization Humans Oocytes Oocytes Pregnancy Pregnancy Rate Severity of Illness Index Tissue and Organ Harvesting

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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License: CC0 · commercial use OK