Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database

Patients with endometriosis have a lower pregnancy rate with in vitro fertilization compared with other diagnoses, with the exception of the small percentage of women in whom endometriosis is the sole infertility-related diagnosis.

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Authors

Suneeta Senapati, M.D., M.S.C.E., Mary D. Sammel, Sc.D., Christopher Morse, M.D., Kurt T. Barnhart, M.D., M.S.C.E.

Abstract

Objective

To assess the impact of endometriosis, alone or in combination with other infertility diagnoses, on IVF outcomes.

Design

Population-based retrospective cohort study of cycles from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System database.

Setting

Not applicable.

Patient(s)

A total of 347,185 autologous fresh and frozen assisted reproductive technology cycles from the period 2008–2010.

Intervention(s)

None.

Main Outcome Measure(s)

Oocyte yield, implantation rate, live birth rate.

Result(s)

Although cycles of patients with endometriosis constituted 11% of the study sample, the majority (64%) reported a concomitant diagnosis, with male factor (42%), tubal factor (29%), and diminished ovarian reserve (22%) being the most common. Endometriosis, when isolated or with concomitant diagnoses, was associated with lower oocyte yield compared with those with unexplained infertility, tubal factor, and all other infertility diagnoses combined. Women with isolated endometriosis had similar or higher live birth rates compared with those in other diagnostic groups. However, women with endometriosis with concomitant diagnoses had lower implantation rates and live birth rates compared with unexplained infertility, tubal factor, and all other diagnostic groups.

Conclusion(s)

Endometriosis is associated with lower oocyte yield, lower implantation rates, and lower pregnancy rates after IVF. However, the association of endometriosis and IVF outcomes is confounded by other infertility diagnoses. Endometriosis, when associated with other alterations in the reproductive tract, has the lowest chance of live birth. In contrast, for the minority of women who have endometriosis in isolation, the live birth rate is similar or slightly higher compared with other infertility diagnoses.

Read the full text at: http://www.fertstert.org/article/S0015-0282(16)610...

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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