Treatment of Women with Endometriosis and Subfertility: Results from a Meta-Analysis

Purpose: To compare the pregnancy rates of women with endometriosis to those without endometriosis following controlled ovarian stimulation with intrauterine insemination, IVF/ICSI, or egg donation. The main outcome measures were the clinical pregnancy rates. Material and Methods: Meta-analysis and review of the literature including more than 40 000 treatment cycles. Results: The pregnancy rates following controlled ovarian hyperstimulation (COH) and intrauterine insemination revealed a significantly lower pregnancy rate in women with endometriosis as compared to the control. No significant differences in the pregnancy rates were obtained from IVF/ICSI treatment cycles. The results of egg donation programs provided further evidence that the endometrial receptivity in women with endometriosis is not impaired, but apparently the quality of oocytes with respect to fertilization and implantation is. Conclusion: IVF/ICSI represents an equally effective treatment of infertility in women with endometriosis compared to the control. Hormonal ovarian stimulation in combination with intrauterine insemination by husband in women with endometriosis has been shown to be rather ineffective. These results emphasize the need for attention with respect to the ratifications of national guidelines recommending paths of treatment in women with endometriosis and subfertility. Schlüsselwörter Endometriose - Sterilität - Meta‐Analyse Key words endometriosis - sterility - meta‐analysis

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