Analysis of 2438 cycles for the impact of endometrioma and its surgery on the IVF outcomes

Demirdağ, Erhan; Güler, İsmail; Selvi, İlknur; Akdulum, Münire Funda Cevher; Canan, Sultan; Erdem, Ahmet; Erdem, Mehmet

doi:10.1016/j.ejogrb.2021.06.034

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…A recent study reported that poor response to ovarian stimulation and cycle cancellation were more frequent in patients who had previous endometrioma surgery compared to patients with non-operated endometrioma. This study also reported that the pregnancy rates were similar in patients who had previous endometrioma surgery compared to patients with non-operated endometrioma, which was consistent with our study [23]. However, the majority of published studies suggested that ovarian surgery for endometrioma was associated with impaired IVF outcome in DOR patients.…”

Section: Discussionsupporting

confidence: 91%

Does current ovarian endometrioma increase the time for DOR patients to reach live birth in IVF?

Deng

Yin

et al. 2022

BMC Pregnancy Childbirth

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Background The contents of ovarian endometrioma (OMA) such as inflammatory mediators, reactive oxygen species, and iron may disrupt normal folliculogenesis and result in subsequent oocyte apoptosis. Therefore, women with OMA have a potential risk of diminished ovarian reserve (DOR). The purpose of this study is to compare the in vitro fertilization (IVF) outcomes and efficiency between DOR patients with and without current OMA. Methods This retrospective case-control study included a total of 493 women with DOR (serum anti-Müllerian hormone level < 1.1 ng/mL). Ninety patients with OMA (Group A) underwent 191 IVF cycles and 403 patients without ovarian OMA (Group B) underwent 888 IVF cycles in our center between January 2014 and December 2018. Basal characteristics and IVF outcomes were compared between Group A and Group B. Time to achieve live birth were compared between patients with live birth in two groups (Group A1, 31 patients; Group B1, 132 patients). Results Clinical and demographic characteristics of patients were similar respectively between groups (A vs. B, A1 vs. B1). There were no statistically significant differences in implantation rate, live birth rate per OPU and per ET cycle and the cumulative live birth rate per patient and per patient with good-quality embryos between Group A and Group B (P > 0.05). Total time to achieve live birth has no statistically significant difference between Group A1 and Group B1 (P > 0.05). Conclusion For DOR women, presence of endometrioma did not affect the IVF outcomes. Even the time to get live birth was not prolonged by current OMA.

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Section: Discussionsupporting

confidence: 91%

Does current ovarian endometrioma increase the time for DOR patients to reach live birth in IVF?

Deng

Yin

et al. 2022

BMC Pregnancy Childbirth

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“…Eighteen studies were included in this review [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Five were conducted in Turkey [15,16,18,25,26], 3 in Japan [19,27,28], and 1 in each of the following countries: Canada [31], China [21], Denmark [22], Egypt [23], France [32], Italy [30], Russia [24], Spain [17], South Korea [20], and the USA [29]. Three studies were RCTs [16,23,26], six were prospective cohort [21,22,24,25,30,32], and nine were retrospective cohort studies [15, 17-20, 27-29, 31].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All were single center except three trials [17,31,32] that were conducted in two centers. Six studies compared laparoscopic surgery to no treatment [16-19, 21, 27], five compared surgery to no treatment [15,20,25,26,29], and three compared cyst aspiration to no treatment [20,25,27]. Medical treatment was GnRH in two studies [23,24], OCPs in one study [15], and dienogest in one study [24], while aromatase inhibitors were studied in two trials [22,31].…”

Section: Study Characteristicsmentioning

confidence: 99%

Impact of treatment interventions of endometriomas prior to in vitro fertilization: a systematic review and meta-analysis

Katta,

Maged,

Ogila

et al. 2024

Middle East Fertil Soc J

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Background Treatment of endometrioma before in vitro fertilization (IVF) is challenging as it may affect ovarian response to induction. Objective A systematic review to search for the available optimal management of ovarian endometrioma before ovulation induction in IVF. Search strategy Screening of the MEDLINE, Web of Science, EMBASE, Cochrane database, and the clinical trial registration sites, covering the period from their inception up to June 2023 was done by two reviewers independently using the keywords ovarian endometrioma, ovarian endometriosis, endometrioma/surgery, endometrioma/hormonal treatment, randomized controlled trial(s), case-controlled studies, and cohort studies. Selection criteria All types of studies were included. Participants included were women with unilateral or bilateral ovarian endometriomas candidate for IVF/ICSI. We included 18 studies in the review. Three studies were randomized controlled parallel studies, six were prospective cohort, and nine were retrospective cohort studies. Data collection and analysis Data from all included studies were extracted by two authors (A. M., A. O.) independently. Data extracted included sample size, population characteristics including age, BMI, duration of infertility, ovarian reserve markers, cyst size, and bilaterality and induction protocol used. Main results We found 18 studies. Women with untreated endometrioma had significantly higher numbers of MII oocytes (the mean difference (MD) effect estimate was − 0.53 with [− 1.04, − 0.01] 95% CI and 0.04 P-value), higher number of obtained embryos (MD effect estimate was − 0.25 with [− 0.38, − 0.11] 95%CI and < 0.001 P-value), and required lower doses of gonadotropins for induction (MD effect estimate was 361.14 with [168.13, 5554.15] 95% CI and < 0.001 P-value) compared to those who had undergone surgical management of endometrioma. However, live birth (OR effect estimate was 0.79 with [0.54, 1.18] 95% CI and 0.25 P-value), clinical pregnancy (OR effect estimate was 0.95 with [0.72, 1.26] 95% CI and 0.73 P-value), miscarriage (OR effect estimate was 0.74 with [0.33, 1.63] 95% CI and 0.45 P-value), cancellation rates (OR effect estimate was 1.62 with [0.57, 4.66] 95% CI and 0.37 P-value), and the duration of stimulation (MD effect estimate was 0.19 with [− 0.42, − 0.81] 95% CI and 0.54 P-value) did not show any significant difference between the two groups of women. Hormonal treatment of endometrioma was associated with higher ongoing pregnancy rate (OR effect estimate was 3.39 with [1.83, 6.26] 95% CI and < 0.001 P-value), higher clinical pregnancy rate (OR effect estimate was 3.36 with [2.01, 5.63] 95% CI and < 0.001 P-value), and higher numbers of MII oocytes (MD effect estimate was 2.04 with [0.72, 3.36] 95% CI and 0.003 P-value) when compared to women who did not receive such therapy. These effects were evident in treatment with GnRH agonists, OCPs (oral contraceptive pills), and dienogest, while the miscarriage and cycle cancellation rates did not show these differences. Conclusions The optimal approach for treating endometrioma prior to IVF is not clear yet due to lack of well-designed randomized controlled trials. Registration number CRD42020151736.

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“…Nevertheless, women with ASRM stage I and II endometriosis who underwent surgical removal of all visible endometriosis lesions had significantly improved implantation rates, pregnancy rates, and live birth rates and were noted to have a shorter time to pregnancy and higher cumulative pregnancy rate [ 19 ]. Several studies have evaluated the impact of surgery for endometriomas, including a systematic review and meta-analysis by Alborzi and colleagues, reporting no significant difference in pregnancy rate when compared to other treatments such as surgery combined with IVF, IVF alone or aspiration with or without sclerotherapy followed by IVF [ 76 , 77 ]. Table 2 provides a summary of findings from studies evaluating the management options in women with endometriosis and their impact on oocyte and embryo quality.…”

Section: Management Optionsmentioning

confidence: 99%

Endometriosis, Oocyte, and Embryo Quality

Latif

Sarıdoğan

2023

JCM

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Endometriosis is a common finding among women with infertility, and women who are diagnosed with endometriosis are almost twice as likely to experience infertility. Mechanisms by which endometriosis causes infertility remain poorly understood. In this review, we evaluate the current literature on the impact of endometriosis on oocyte and embryo quality. The presence of endometriosis evidently reduces ovarian reserve, oocyte quality, and embryo quality; however, this does not appear to translate to a clear clinical impact. Analysis of data from large assisted reproduction technology registries has shown that women with endometriosis have a lower oocyte yield but no reduction in reproductive outcomes. There is a need for future studies in the form of well-designed randomized controlled trials to further evaluate the role of surgical and medical treatment options in women with endometriosis undergoing assisted conception.

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Analysis of 2438 cycles for the impact of endometrioma and its surgery on the IVF outcomes

Cited by 7 publications

References 28 publications

Does current ovarian endometrioma increase the time for DOR patients to reach live birth in IVF?

Does current ovarian endometrioma increase the time for DOR patients to reach live birth in IVF?

Impact of treatment interventions of endometriomas prior to in vitro fertilization: a systematic review and meta-analysis

Endometriosis, Oocyte, and Embryo Quality

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