Risk of miscarriage in women with endometriosis undergoing IVF fresh cycles: a retrospective cohort study

Puyu Yang, Yang Wang, Zhangxin Wu, Ningning Pan, Liying Yan, Caihong Ma
Reproductive biology and endocrinology : RB&E · 2019 · vol. 17(1) , pp. 21 · doi:10.1186/s12958-019-0463-1 · PMID:30755216 · PMC6371538 · W2946284281
article OA: gold CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study found no statistically significant increase in miscarriage risk for women with endometriosis undergoing IVF fresh cycles compared to women without endometriosis.

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

This retrospective cohort study evaluated whether endometriosis affects miscarriage risk among women who achieved singleton pregnancies after first IVF fresh embryo transfer at a tertiary reproductive center (2008–2016), comparing 1006 women with surgically diagnosed endometriosis (including ovarian endometrioma) versus 2012 matched women without endometriosis. Miscarriage (loss of clinical pregnancy before 24 weeks) occurred at similar rates between groups (22.4% with endometriosis vs 20.1% without; adjusted OR 1.14, 95% CI 0.95–1.37), and logistic regression adjusting for miscarriage risk factors showed no significant increase in endometriosis-related miscarriage risk. Within the endometrioma subgroup, miscarriage rates were not significantly different by presence of endometrioma or by endometrioma size categories (including ≥30 mm vs <30 mm) after adjustment. This paper does not explicitly discuss endometriosis and adenomyosis separately; it directly addresses endometriosis and shows no statistically increased miscarriage risk in women with endometriosis undergoing IVF fresh cycles, with additional subgroup analyses by ovarian endometrioma size.

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Abstract

BACKGROUND: Endometriosis is thought to affect the effectiveness of ART by an increased risk of miscarriage. We aimed to investigate the impact of endometriosis in women achieving singleton pregnancies through IVF fresh cycles and risk of miscarriage. METHODS: This retrospective cohort study included all women undergoing a first IVF cycle and achieving singleton pregnancies after fresh embryo transfer in a tertiary university hospital reproductive medical center between January 2008 and June 2016. Women with endometriosis were compared with women with no endometriosis. Women in the endometriosis group were all with a history of laparoscopy or laparotomy for endometriosis and/or with ovarian endometrioma. The control group was matched 1:2 according to age and study period. RESULTS: Among the cohort, we identified 1006 women with endometriosis as study group and 2012 unaffected women matched in a 1:2 ratios as control group. The miscarriage rate between women with and without endometriosis was similar (22.4 and 20.1%, P = 0.085). The odds ratio after adjusting for the risk factors for miscarriage was 1.14 (95% confidence interval 0.95-1.37). In the study group, the women with and without endometrioma did not show a significant risk of miscarriage, (19.8 and 23.8%, P = 0.152, OR 0.79, 95% CI 0.58-1.09). The miscarriage rate in women with endometrioma ≥30 mm (37.3 ± 7.1 mm) and < 30 mm (19.3 ± 5.5 mm) was not significantly different, (24.7 and 18.5%, P = 0.229, OR 1.44, 95% CI 0.79-2.63). After adjustment for risk factors for miscarriage, the presence of endometrioma and the size of endometrioma, regression model confirmed no significant increase for the risk of miscarriage in the subgroup analyses. CONCLUSIONS: The risk of miscarriage did not statistically increase in women with endometriosis who achieved pregnancy through IVF fresh cycles.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Abortion, Spontaneous Endometriosis Fertilization in Vitro Abortion, Spontaneous Adult Embryo Transfer Embryo Transfer Endometriosis Female Fertilization in Vitro Hospitals, University Humans Pregnancy Pregnancy Rate Retrospective Studies Risk Assessment Risk Factors Tertiary Care Centers

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