Deep infiltrating endometriosis is a determinant factor of cumulative pregnancy rate after intracytoplasmic sperm injection/in vitro fertilization cycles in patients with endometriomas

Ballester M, Marcos Ballester, Anne Oppenheimer, Oppenheimer A, Emmanuelle Mathieu d’Argent, Emmanuelle Mathieu d'Argent, Mathieu d'Argent E, Touboul C, Cyril Touboul, Antoine JM, Jean-Marie Antoine, Michelle Nisolle, Nisolle M, Daraï E, Emile Daraï, Émile Daraï
Fertility and sterility · 2011 · vol. 97(2) , pp. 367–372.e3 · doi:10.1016/j.fertnstert.2011.11.022 · PMID:22177465 · W2116823945
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Deep infiltrating endometriosis was identified as a key factor influencing cumulative pregnancy rates following intracytoplasmic sperm injection/in vitro fertilization cycles in patients with endometriomas.

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Abstract

ObjectiveTo evaluate the cumulative pregnancy rate (CPR) per patient after in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI) cycles in patients with endometriomas and to evaluate the determinant factors of CPR per patient.DesignRetrospective study from January 2007 to October 2008.SettingTertiary care university hospital.Patient(s)103 patients who had undergone IVF treatment, comprising isolated endometriomas (n = 30) and endometriomas with associated deep infiltrating endometriosis (DIE) (n = 73).Intervention(s)None.Main outcome measure(s)Clinical pregnancy rate after IVF-ICSI cycle.Result(s)The total number of cycles was 162, and the median number of cycles per patient was 1 (1 to 5). Fifty-eight women (56.3%) became pregnant. The total number of endometriomas and size of the largest endometrioma and bilateral endometriomas had no impact on the CPR per patient. Using multivariable analysis, the associated DIE and antimüllerian hormone serum level (≤ 1 ng/mL) were independent factors associated with a decrease in the pregnancy rate per patient. Overall, the CPR per patient was 73.7%, and it increased until the third cycle with no benefit for additional cycles. The CPR per patient for women with isolated endometriomas and women with endometriomas and associated DIE was 82.5% and 69.4%, respectively.Conclusion(s)Associated DIE has a negative impact on assisted reproduction results in patients with endometriomas. Moreover, our data show that after three IVF-ICSI cycles the CPR per patient is not improved and that surgery should be considered.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Fertilization in Vitro Infertility, Female Sperm Injections, Intracytoplasmic Adult Chi-Square Distribution Endometriosis Endometriosis Female Hospitals, University Humans Infertility, Female Infertility, Female Infertility, Female Kaplan-Meier Estimate Male Multivariate Analysis Paris Pregnancy Pregnancy Rate

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