ABSTRACT
Research question
What are the reproductive outcomes and the prognostic factors of live birth rates
in endometriosis patients referred to oocyte donation after multiple IVF-failures?
Design
Observational cohort study including all women with endometriosis-related infertility
and ≥ 2 failed IVF/ICSI cycles referred to oocyte donation who consulted at our institution
between January 2013 and June 2022. Endometriosis was diagnosed based on published
imaging criteria and confirmed histologically in women who had a history of surgery
for endometriosis. The main outcome measured was the cumulative live birth rate(CLBR).
We compared the characteristics of women who had a live birth versus those who did
not using univariate and multivariate analysis to identify determinant factors of
fertility outcome.
Results
Fifty-seven patients underwent 90 oocyte donation cycles, after 244 failed autologous
IVF cycles. The mean age of the population was 36.8 ± 3.3 years, with a mean infertility
duration of 3.6 ± 2.2 years, and a mean number of autologous IVF/ICSI cycles of 4.4
± 2.3 cycles per patient. Three patients (5.3%) had superficial endometriosis, 2 patients
(3.5%) had ovarian endometriomas, and 52 patients (91.2%) had deep infiltrating endometriosis,
among which 30 patients (57.7%) had bowel lesions. Thirty patients (52.6%) had associated
adenomyosis. Overall, the CLBR per patient was 36/57 (63.2%). After multivariate analysis,
only being nulligravida (p = 0.002) remained an independent negative predictive factor
of the live birth rate.
Conclusion
Our study suggests that, in women with endometriosis-related infertility and recurrent
IVF failures, oocyte donation appears to be a viable option to optimize the live birth
rate.
KEYWORDS
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Biography
Pr Pietro Santulli graduated from the University Paris Descartes. He was appointed Professor in 2018. He is in charge of the Reproductive Medicine Unit in the department headed by Professor Chapron at Cochin University Hospital in Paris. His main research activities focus on assessment and management on endometriosis and assisted reproductive technologies.
KEY MESSAGE
In women with endometriosis-related infertility and recurrent IVF failures, oocyte donation appears to be a viable option to optimize the live birth rate, which reached 63.2%. In this specific population, poor embryo quality may be a key limiting factor of autologous ART success rates, rather than impaired endometrial receptivity.
Article info
Publication history
Accepted:
May 17,
2023
Received in revised form:
May 5,
2023
Received:
February 3,
2023
CITY: PARIS COUNTRY: FRANCEPublication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd.
