Ovarian stimulation and endometriosis progression or recurrence: a systematic review

Edgardo Somigliana, Somigliana E, Paola Viganò, Laura Benaglia, Benaglia L, Andrea Busnelli, Alessio Paffoni, Paolo Vercellini
Reproductive BioMedicine Online · 2018 · vol. 38(2) , pp. 185–194 · doi:10.1016/j.rbmo.2018.11.021 · PMID:30609970 · W2905916324
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This systematic review examined the relationship between ovarian stimulation treatments and the progression or recurrence of endometriosis.

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Abstract

Available evidence on the impact of ovarian stimulation on the progression of endometriosis or its recurrence was systematically reviewed. Data from ovarian stimulation alone, or associated with intrauterine insemination (IUI) or IVF, were included. Sixteen studies were selected. Initial case reports (n = 11) documented some severe clinical complications. However, subsequent observational studies were more reassuring. Overall, five conclusions can be drawn: (i) IVF does not worsen endometriosis-related pain symptoms (moderate quality evidence); (ii) IVF does not increase the risk of endometriosis recurrence (moderate quality evidence); (iii) the impact of IVF on ovarian endometriomas, if present at all, is mild (low quality evidence); (iv) IUI may increase the risk of endometriosis recurrence (low quality evidence); (v) deep invasive endometriosis might progress with ovarian stimulation (very low quality evidence). In conclusion, available evidence is generally reassuring (at least for IVF) and does not justify aggressive clinical approaches such as prophylactic surgery before assisted reproductive technology treatment to prevent endometriosis progression or recurrence. However, further evidence is required before being able to reach definitive conclusions. In particular, the potential effects on deep invasive endometriosis and the possible synergistic effect of stimulation and pregnancy are two areas that need to be explored further.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Infertility, Female Ovulation Induction Disease Progression Endometriosis Endometriosis Female Fertilization in Vitro Fertilization in Vitro Humans Ovulation Induction Recurrence

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.

References (55)

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