Abstract
Research Question
Does moderate to severe endometriosis have an impact on cumulative live birth rates
and in vitro fertilization outcomes?
Design
In our retrospective matched cohort study, women with moderate to severe endometriosis
undergoing in vitro fertilization or intracytoplasmic sperm injection treatment from
January 2015 to December 2020, were matched 1:2 to women with other etiologies of
infertility. Our main outcome was the cumulative live birth rate per cycle and per
woman, and secondary outcomes were the number of oocytes retrieved and number of mature
oocytes, fertilization rate, total number of embryos and usable embryos, implantation
rate, pregnancy rate, miscarriage rate per cycle.
Results
A total of 195 women with endometriosis were matched with 390 women without endometriosis
representing 323 and 646 cycles respectively. Women with endometriosis had significantly
fewer oocytes retrieved than women in the control group, despite higher doses of gonadotropins,
but a similar number of mature oocytes, fertilization rate, total number of embryos
and usable embryos. Cumulative live birth rate per cycle and per women were not significantly
different between both groups (19.8% vs. 24.1%, p = 0.13 and 32.3% vs. 37.2%, p = 0.24
respectively). In women with endometrioma, a history of cystectomy did not impact
the cumulative live birth rate per cycle (28.3% vs. 31.9%, p = 0.68). Tobacco use
does not have a worse impact when associated with endometriosis compared to the control
group (16.4% vs. 25.9%, p = 0.13).
Conclusion
After excluding bias of confusion thanks to a matched cohort study, we did not observe
a significant impact of moderate to severe endometriosis on the in vitro fertilization
cumulative live birth rate. Our data are reassuring for the counselling of infertile
women with endometriosis before in vitro fertilization.
Keywords
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Biography
My name is Appoline Zimmermann and I am a French MD in gynaecology specialising in reproductive medicine. I recently graduated from the University of Aix-Marseille and am currently working at the Center for Reproductive Medicine, Aix-Marseille University Hospital.
Article info
Publication history
Accepted:
February 23,
2023
Received in revised form:
February 3,
2023
Received:
November 21,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
