OP03.05: Ovarian response to the gonadotropins during IVF or ICSI cycles in patients with presence of deep infiltrating endometriosis based on ultrasonography

To compare the ovarian response to the gonadotropins in patients with deep infiltrating endometriosis based on ultrasonography (US) with or without previous ovarian surgery for endometrioma. We also compared these responses in unexplained, DOR (diminished ovarian reserve), male, and tubal infertility groups. 302 patients (719 cycles) submitted to IVF or ICSI cycles were divided in 5 groups on the basis of diagnosis: 1) 50 patients (n=88 cycles) with endometriosis [divided in patients with deep infiltrating endometriosis based on US with (group 1A, n: 22 patients, 50 cycles) or without previous ovarian surgery for endometrioma (group 1B, 28 patients, 38 cycles); 2) 56 patients (280 cycles) with unexplained infertility; 3) 69 patients (128 cycles) with DOR; 4) 94 patients (162 cycles) with male infertility; 5) 33 patients (61 cycles) with tubal infertility. We compared the units of gonadotropins administered, number of follicle >16 mm, estradiol levels and ultrasonographic endometrial thickness at hCG day administration, oocytes recruited, the rate of cancellation due to inaccessible ovaries and a poor outcome response defined as number of follicle ≤2 at hCG administration day or no recovery of oocytes at pick-up. We observed that patients of group 1B have less poor outcome (35% vs 59%; p = 0.05) and more follicle (4.7±3.4 vs 2.3±2.1; p=0.002) in comparison with patients of group 1A. The group 1B was also similar in term of poor outcome and number of follicles with cycles of patients with unexplained, male, and tubal infertility but better to patients with DOR (p= 0.003 and 0.002, respectively). On the contrary patients of group 1A are similar to DOR patients for poor outcome and number of follicle. The rate of inaccessible ovaries is higher group 1A and B. The presence of deep endometriosis evaluated using US without previous ovarian surgery for endometrioma do not seem reduce the ovarian response to the gonadotropins during IVF and ICSI.