Effects of Endometriomas on Ooccyte Quality, Embryo Quality, and Pregnancy Rates in In Vitro Fertilization Cycles: A Prospective, Case-Controlled Study

Elena Yanushpolsky, Yanushpolsky EH, E H Yanushpolsky, Best CL, C L Best, Craig L. Best, Katharine V. Jackson, Jackson KV, K V Jackson, R N Clarke, Clarke RN, Robert N. Clarke, R L Barbieri, Barbieri RL, Robert L. Barbieri, Mark D. Hornstein, Hornstein MD, M D Hornstein
Journal of assisted reproduction and genetics · 1998 · vol. 15(4) , pp. 193–197 · doi:10.1023/a:1023048318719 · PMID:9565848 · PMC3454934 · W1502831380
article OA: bronze CC0 ⤵ 118 in-corpus citations
📄 Open PDF Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06+body, 2026-06-07 ⓘ

Endometriomas were associated with higher early pregnancy loss rates, and potentially fewer oocytes retrieved and poorer embryo quality compared to women without complex cysts.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This prospective case-control study evaluated whether endometriomas present at the time of oocyte retrieval affect IVF outcomes by comparing 45 women with “chocolate” cysts (with cyst fluid CA 125 measured to distinguish true endometriomas) versus 57 controls without complex ovarian cysts. IVF outcomes were assessed in relation to oocyte quantity/quality proxies, embryo development (including reaching at least the four-cell stage 48 hours after retrieval), and pregnancy outcomes. Women with true endometriomas had a significantly higher rate of early pregnancy loss (47% vs 14%) and showed a trend toward fewer oocytes retrieved and fewer embryos reaching the four-cell stage. Limitations include the modest sample size and the observational design, which restricts firm causal inference about mechanisms. This paper is centrally about endometriosis—specifically, how endometriomas at IVF oocyte retrieval relate to oocyte quality, embryo quality, and early pregnancy loss rates.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

PurposeThe effect of endometriomas on oocyte quality, embryo quality, and pregnancy rates in in vitro fertilization (IVF) cycles was evaluated.MethodsForty-five women had "chocolate" cysts aspirated at the time of oocyte retrieval, and cyst fluid CA 125 levels were measured to ascertain presence of "true" endometriomas. Fifty-seven women without any complex cysts at the time of oocyte retrieval served as controls. IVF cycle outcome parameters were compared between the two groups.ResultsWomen with endometriomas experienced a significantly higher rate of early pregnancy loss compared to controls (47 vs 14%). There was also a trend toward fewer oocytes retrieved and fewer embryos reaching at least the four-cell stage 48 hr after retrieval in patients with true endometriomas vs controls.ConclusionsThe presence of endometriomas at the time of oocyte retrieval is associated with increased rates of early pregnancy losses. The number of oocytes retrieved and the embryo quality may also be affected adversely in the presence of endometriomas.
Full text 5,338 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Abstract

Purpose: The effect of endometriomas on oocyte quality, embryo quality, and pregnancy rates in in vitro fertilization (IVF) cycles was evaluated.

Methods

Forty-five women had “chocolate” cysts aspirated at the time of oocyte retrieval, and cyst fluid CA 125 levels were measured to ascertain presence of “true” endometriomas. Fifty-seven women without any complex cysts at the time of oocyte retrieval served as controls. IVF cycle outcome parameters were compared between the two groups.

Results

Women with endometriomas experienced a significantly higher rate of early pregnancy loss compared to controls (47 vs 14%). There was also a trend toward fewer oocytes retrieved and fewer embryos reaching at least the four-cell stage 48 hr after retrieval in patients with true endometriomas vs controls.

Conclusions

The presence of endometriomas at the time of oocyte retrieval is associated with increased rates of early pregnancy losses. The number of oocytes retrieved and the embryo quality may also be affected adversely in the presence of endometriomas. Similar content being viewed by others

References

Mahmood TA, Templeton A: Prevalence and genesis of endometriosis. Hum Reprod 1991;6:544–549 Olive DL, Schwartz LB: Endometriosis. N Engl J Med 1993;328: 1759–1769 Paulson JD, Asmar P, Saffan DS: Mild and moderate endometriosis: Comparison of treatment modalities for infertile couples. J Reprod Med 1991;36:151–155 Marcoaux S, Maheux R, Berube S, et al.: Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med 1997;337:217–222 Mahmood TA, Templeton A: Pathophysiology of mild endometriosis: Review of literature. Hum Reprod 1990;5:765–784 Olive DL, Lee KL: Analysis of sequential treatment protocols for endometriosis-associated infertility. Am J Obstet Gynecol 1986;154:613–619 Telimaa S: Danazol and medroxyprogesterone acetate inefficatious in the treatment of infertility in endometriosis. Fertil Steril 1988;50:872–875 Matson PL, Yovich JL: The treatment of infertility associated with endometriosis by in vitro fertilization. Fertil Steril 1986;46:432–434 Yovich JL, Matson PL, Richardson PA, Hilliard C: Hormonal profiles and embryo quality in women with severe endometriosis treated by in vitro fertilization and embryo transfer. Fertil Steril 1988;50:308–313 Dlugi AM, Loy RA, Dieterle S, Bayer SR, Seibel MM: The effect of endometriomas on in vitro fertilization outcome. J In Vitro Fert Embryo Transfer 1989;6:338–341 Koninckx P, Muyldermans M, Moerman P, Mueleman C, Deprest J, Cornille F: CA 125 concentrations in ovarian “chocolate” cyst fluid can differentiate an endometriotic cyst from a cystic corpus luteum. Hum Reprod 1992;7:1314–1317 The American Fertility Society: Revised American Fertility Society classification of endometriosis. Fertil Steril 1985;43:351–352 Jackson KV, Nurredin A, Clarke RN, Hornstein MD, Rein MS, Friedman AJ: The appearance of one-pronuclear human oocytes is associated with better ovulation-induction response and successful pregnancy outcome. Fertil Steril 1992;58:366–372 Stewart EA, Jackson KV, Friedman AJ, Rein MS, Fox JH, Hornstein MD: The effect of baseline complex ovarian cysts on in vitro fertilization outcome. Fertil Steril 1992;57: 1274–1278 Dawson KJ, Conaghan J, Ostera GR, Winston RML, Hardy K: Delaying transfer to the third day post-insemination, to select non-arrested embryos, increases development to the fetal heart stage. Hum Reprod 1995;10:177–182 Grillo JM, Gamerre M, Lacroix O, Noizet A, Vitry G: Influence of the morphological aspect of embryos obtained by in vitro fertilization on their implantation rate. J In Vitro Fert Embryo Transfer 1991;8:317–321 Arici A, Oral E, Bukulmez O, Duleba A, Olive DL, Jones EE: The effect of endometriosis on implantation: Results from the Yale University in vitro fertilization and embryo transfer program. Fertil Steril 1996;65:603–607 Dicker D, Goldmlan GA, Ashkenazi J, Feldberg D, Voliovitz I, Goldman JA: The value of pretreatment with gonadotrophin releasing hormone (GnRH) analogue in IVF-ET therapy of severe endometriosis. Hum Reprod 1990;5:418–420 Sung L, Mukherjee T, Takeshige T, Bustillo M, Copperman AB: Endometriosis is not detrimental to embryo implantation in oocyte recipients. J Assist Reprod Genet 1997;14:152–156 Hornstein MD: Endometriosis and spontaneous abortion. In Recurrent Pregnancy Loss, Infertility and Reproductive Medicine, AJ Friedman (guest editor), Clinics of North America. Philadelphia, W. B. Saunders, 1991, pp. 175–185 Olivennes F, Feldberg D, Liu HC, Cohen J, Moy F, Rosenwaks Z: Endometriosis: A stage by stage analysis—The role of in vitro fertilization. Fertil Steril 1995;64:392–398 Penzias AS, Jones EE, Seifer DB, Grifo JA, Thatcher AA, DeCherney AH: Baseline ovarian cysts do not affect clinical response to controlled ovarian hyperstimulation. Fertil Steril 1992;57:1017–1021 Author information Authors and Affiliations Rights and permissions About this article Cite this article Yanushpolsky, E.H., Best, C.L., Jackson, K.V. et al. Effects of Endometriomas on Ooccyte Quality, Embryo Quality, and Pregnancy Rates in In Vitro Fertilization Cycles: A Prospective, Case-Controlled Study. J Assist Reprod Genet 15, 193–197 (1998). https://doi.org/10.1023/A:1023048318719 Issue date: DOI: https://doi.org/10.1023/A:1023048318719

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

MeSH descriptors

Embryo, Mammalian Endometriosis Fertilization in Vitro Oocytes Pregnancy Rate CA-125 Antigen CA-125 Antigen Case-Control Studies Demography Embryo, Mammalian Endometriosis Endometriosis Female Humans Oocytes Ovarian Cysts Ovarian Cysts Ovarian Cysts Pregnancy Pregnancy Complications

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 (24)

Cited by (50)

Source provenance

europepmc
last seen: 2026-07-27T06:15:28.040536+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-05-13T22:10:40.754221+00:00
License: CC0 · commercial use OK