Endométriose et infertilité : la stimulation hormonale en cours de Fécondation In Vitro a t-elle un impact sur l'évolution de la maladie ?

Introduction: Magnetic resonance imaging (MRI) and ultrasound scanning are complementary in the diagnosis of endometriosis. Fusion is a new technique with encouraging preliminary results in the evaluation of deep endometriosis. The main objective of our study is to evaluate the evolution of endometriosis lesions in patients with IVF using MRI fusion ultrasound. Materials & Methods: Between November 2017 and November 2018,we conducted an observational, prospective, mono-centric, cohort study within the Reproductive Medicine Department of the University Hospital of Grenoble Alpes. The main endpoint was the size of each endometriosis lesions in fusion ultrasound before and after IVF, obtained by averaging the measurements of the 3 diameters when they were measurable,or the measurement of the largest axis of the lesion. In the absence of pregnancy, a second evaluation, the cycle following IVF, was performed. Results: Between November 2017 and October 2018, 564 patients underwent IVF at Grenoble University Hospital. 47 had endometriosis lesions, 20 agreed to participate in the study and received initial imaging. Among these, 10 underwent second evaluation the cycle following IVF and were thus included. No new lesions were detected after the hormonal stimulation protocol. The mean size of the deep lesions before IVF was 16.5±7.8 mm compared to 20.62 ± 11.1 mm after IVF with an insignificant difference (p=0.54). There was no significant difference in the size of endometriomas before and after IVF (21.3 ± 8 mm / 19 ± 10.1 mm, p = 0.95). Conclusion: Fusion imaging for endometriosis diagnosis is a new technique that is feasible and reproducible.Hormonal stimulation during IVF does not appear to have an impact on the evolution of the size of endometriosis lesions.