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Influence of endometrioma size on ART outcomes

  • Author Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    Mathilde Bourdon
    Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
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  • Author Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    Yaniv Dahan
    Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    Affiliations
    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
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  • Chloé Maignien
    Affiliations
    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
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  • Catherine Patrat
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Histology-Embryology and Reproductive Biology, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France
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  • Corinne Bordonne
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Radiology, Centre Hospitalier Universitaire (CHU) Hotel Dieu, Paris, France
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  • Louis Marcellin
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
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  • Author Footnotes
    † The authors consider that the last two authors should be regarded as joint last authors.
    Charles Chapron
    Footnotes
    † The authors consider that the last two authors should be regarded as joint last authors.
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
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  • Author Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    ,
    Author Footnotes
    † The authors consider that the last two authors should be regarded as joint last authors.
    Pietro Santulli
    Correspondence
    Corresponding author.
    Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    † The authors consider that the last two authors should be regarded as joint last authors.
    Affiliations
    Université de Paris, Faculté de Médecine, Paris, France

    Assistance Publique–Hôpitaux de Paris (AP–HP), Hôpitaux Universitaires Paris Centre (HUPC), Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France

    Department 3I ‘Infection, Immunité et Inflammation’, Institut Cochin, INSERM U1016, Paris, France
    Search for articles by this author
  • Author Footnotes
    # The authors consider that the first two authors should be regarded as joint first authors.
    † The authors consider that the last two authors should be regarded as joint last authors.
Published:August 11, 2022DOI:https://doi.org/10.1016/j.rbmo.2022.08.097

      Abstract

      Research question

      Does endometrioma size affect the number of oocytes retrieved after ovarian stimulation in women with endometriosis-related infertility undergoing IVF/intracytoplasmic sperm injection (ICSI)?

      Design

      Cohort study of infertile women with unilateral or bilateral endometrioma(s) associated with deep infiltrating endometriosis, undergoing their first IVF/ICSI cycle between January 2014 and November 2021. A total of 326 women with an adequate imaging work-up with transvaginal ultrasound and/or magnetic resonance imaging performed by senior radiologists before the start of ovarian stimulation was included. Prognostic factors associated with the number of oocytes retrieved were analysed. IVF/ICSI outcomes were compared between five groups defined according to the largest endometrioma diameter (<2, 2 to <4, 4 to <6, 6 to <8 and ≥8 cm).

      Results

      Factors that significantly reduced the number of oocytes retrieved after adjustment by multiple linear regression were women's age (regression coefficient –0.18; 95% confidence interval [95% CI] –0.31 to–0.06; P = 0.005), smoking habit (–2.02; 95% CI –3.42 to -0.62; P = 0.005), day 3 FSH concentration (–0.20; 95% CI –0.39 to –0.02; P = 0.031) and a previous history of surgery for ovarian endometriosis (–1.32; 95% CI –2.63 to –0.02; P = 0.047). Antral follicle count and oestradiol concentration on the trigger day were positively correlated with the number of oocytes retrieved (0.14; 95% CI 0.08 to 0.19; P < 0.001 and 0.003; 95% CI 0.002 to 0.004; P < 0.001, respectively). The mean number of oocytes retrieved was not significantly different between the five groups (P = 0.413), nor were the cumulative live birth rate, the number of cancelled cycles and perinatal outcomes.

      Conclusions

      No significant difference in the number of oocytes retrieved was observed according to endometrioma size. This study suggests that ovarian stimulation can be of benefit to women irrespective of the endometrioma size.

      Keywords

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      Biography

      Professor Pietro Santulli graduated from the University Paris-Descartes (MD, PhD), and is now in charge of the fertility unit at Cochin University Hospital in Paris. His main research activities are clinical and basic research on endometriosis- and adenomyosis-related infertility and clinical research on assisted reproductive technologies in infertility.
      Key message
      Endometrioma(s) size does not appear to influence the assisted reproductive technology outcomes in infertile women with endometriosis: no significant differences were found in the number of oocytes retrieved, the number of cancelled cycles, the cumulative live birth rate or obstetrical outcomes.