Ovarian reserve markers and assisted reproductive technique (ART) outcomes in women with advanced endometriosis

Safiya Abdulkareem Wahd, Safiya A Wahd, Shahla Alalaf, Shahla K Alalaf, Talha Al‐Shawaf, Talha Al-Shawaf, Namir Al-Tawil, Namir G Al-Tawil
Reproductive biology and endocrinology : RB&E · 2014 · vol. 12(1) , pp. 120 · doi:10.1186/1477-7827-12-120 · PMID:25442239 · W2147223112
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Antral follicle count and age best predicted oocyte yield in ICSI cycles for women with advanced endometriosis, who also showed lower live birth rates, especially those with prior endometrioma surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This prospective study evaluated whether ovarian reserve markers (antral follicle count [AFC], serum anti-Müllerian hormone, FSH, and age) predict controlled ovarian stimulation response measured by the number of mature (MII) oocytes retrieved and compared ART outcomes in 285 infertile women undergoing their first ICSI cycle, with endometriosis stages III–IV versus surgically confirmed absence of endometriosis controls. Women with advanced endometriosis retrieved significantly fewer mature oocytes than controls, and the number of mature oocytes was best predicted by AFC and age; in women with a history of endometrioma surgery, only AFC predicted outcomes. Live birth rates were lower in endometriosis overall but not significantly, whereas previous endometrioma surgery was associated with significantly fewer live births. The authors’ main limitation noted in the design is that the clinical outcomes were evaluated within a first-cycle cohort with specific inclusion/exclusion criteria (e.g., excluding PCOS and other endocrine disease). This paper is centrally about endometriosis — it analyzes ovarian reserve markers and ICSI outcomes specifically in women with advanced endometriosis and how prior endometrioma surgery affects mature oocyte yield and live birth rates.

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Abstract

BACKGROUND: The role of ovarian reserve markers as predictors of the controlled ovarian stimulation (COS) response in intracytoplasmic sperm injection (ICSI) cycles in women with endometriosis has been much debated. The aim of the present study is to assess the predictability of ovarian reserve markers for the number of mature oocytes (MII) retrieved and to assess the pregnancy rate and live birth rate in women with advanced endometriosis. METHODS: Two hundred eighty-five infertile women who had laparoscopy followed by a first ICSI cycle were recruited in this prospective study. One hundred ten patients were diagnosed with endometriosis stage III-IV (group 1), and 175 patients had no endometriosis (group II). Sixty-three patients in group 1 had no history of previous endometrioma surgery (group Ia), and 47 patients had a history of previous endometrioma surgery (group Ib). RESULTS: The number of mature oocytes retrieved was significantly lower in women with advanced endometriosis than in women with no endometriosis. The number of mature oocytes retrieved in women with and without endometriosis was best predicted by antral follicle count (AFC) and age, whereas only AFC was a predictor in women with previous endometrioma surgery (odds ratio: 0.49; 95% confidence interval: 0.13-0.60). Women with endometriosis had a lower rate of live births than the control group, but this difference was not statistically significant; the number of live births was significantly lower in those with previous endometrioma surgery. CONCLUSIONS: The best predictor of the COS response in ICSI was AFC, followed by age. Women receiving ICSI following surgery for ovarian endometrioma had a poorer clinical outcome and lower rate of live births compared with those with endometriosis but no previous surgery and the control group.

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Condition tags

mesh:D004715endometriosisendometrioma

MeSH descriptors

Endometriosis Live Birth Ovarian Reserve Pregnancy Rate Reproductive Techniques, Assisted Adult Analysis of Variance Cross-Sectional Studies Endometriosis Endometriosis Endometriosis Female Humans Infant, Newborn Linear Models Oocyte Retrieval Oocyte Retrieval Ovarian Follicle Ovarian Follicle Ovarian Follicle

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