Assisted reproduction in endometriosis

Ziegler, Dominique de; Pirtea, Paul; Carbonnel, Marie; Poulain, Marine; Cicinelli, Ettore; Bulletti, Carlo; Kostaras, Konstantinos; Kontopoulos, George; Keefe, David L.; Ayoubi, Jean Marc

doi:10.1016/j.beem.2018.10.001

Cited by 37 publications

(20 citation statements)

References 72 publications

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“…Given the estrogen-dependence associated with endometriosis, it is plausible that hyper-stimulation associated with assisted reproduction treatment may exacerbate the disease process and adversely affect endometrial receptivity and subsequent implantation; in this way, it has been proposed that a freeze-all deferred ET approach would mitigate these effects and improve IVF outcomes in patients with endometriosis [ 6 , 7 ]. However, controversy exists regarding the mechanism of endometriosis-associated infertility and the purported benefits of deferred ET with respect to endometrial receptivity [ 1 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Early Pregnancy Outcomes in Fresh Versus Deferred Embryo Transfer Cycles for Endometriosis-Associated Infertility: A Retrospective Cohort Study

Tan

Cerrillo

Cruz

et al. 2021

JCM

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Given the estrogen-dependence associated with endometriosis, hyper-stimulation associated with assisted reproduction treatment may exacerbate the disease process and adversely affect endometrial receptivity and subsequent implantation. In this way, a freeze-all deferred embryo transfer (ET) approach may benefit patients with endometriosis, although controversy exists regarding the mechanism of endometriosis-associated infertility and benefits of deferred ET on endometrial receptivity. Hence, the purpose of this study was to compare in vitro fertilization (IVF) outcomes in women with endometriosis, diagnosed by histology, undergoing fresh versus deferred-ET after elective cryopreservation. Of the 728 women included, no significant differences were observed in baseline patient characteristics and response to gonadotrophin stimulation between fresh and deferred ET groups. Furthermore, no significant differences in implantation rate (49.7 vs. 49.9%, p = 0.73), clinical pregnancy rate (40.9 vs. 39.9%, p = 0.49), and miscarriage rate (9.4 vs. 9.9%, p = 0.63) were observed between fresh and deferred ET groups, respectively. Hence, contrary to previous studies, our results suggest that a deferred ET “freeze-all” IVF strategy does not improve early pregnancy outcomes among women with endometriosis. However, prospective studies are required to validate these findings and further insight into the etiology and pathogenesis of endometriosis-associated infertility are necessary to optimize IVF protocols in this population.

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Section: Introductionmentioning

confidence: 99%

Early Pregnancy Outcomes in Fresh Versus Deferred Embryo Transfer Cycles for Endometriosis-Associated Infertility: A Retrospective Cohort Study

Tan

Cerrillo

Cruz

et al. 2021

JCM

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“…More than half of these pregnancies had been conceived spontaneously without ART [84,85]. The chances of conceiving naturally are especially high in the first 12-18 months after the operation [86]. Nevertheless, a surgical approach always has to be weighed against the risks: the impairment of ovarian function after the excision of endometriomas, as well as surgical complications, such as infections, thrombosis, embolism, and others.…”

Section: Surgical Treatment and Assisted Reproductive Technology (Art)mentioning

confidence: 99%

“…Therefore, in particular, patients with few symptoms and already reduced ovarian reserve (decrease in AMH level) with endometriomas should be scheduled for immediate ART. The surgical approach should be omitted to avoid decreasing the ovarian function and follicular reserve any further by inevitable surgical damage of the ovaries [86]. Improving ART techniques over the last few years promoted the "freeze-all" strategy.…”

Section: Surgical Treatment and Assisted Reproductive Technology (Art)mentioning

confidence: 99%

Pathogenesis of Endometriosis: The Origin of Pain and Subfertility

Gruber

Mechsner

2021

Cells

109

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Endometriosis (EM) and adenomyosis (AM) are common conditions with pain and infertility as the principal symptoms. The pathophysiology of pain in EM and AM comprises sensory and somatoform pain mechanisms. Over time, these may aggravate and lead to individual complex disease patterns if not diagnosed and treated. Despite the known facts, several years often pass between the onset of symptoms and diagnosis. Chronic pain disorders with changes on a neuronal level frequently arise and are linked to depressive disorders, with the process becoming a vicious cycle. Additionally, women with EM and AM suffer from sub- and infertility. Low fecundity rates are caused by anatomical changes in combination with behavioral changes in the sexual activity of women with chronic pain as well as local proinflammatory factors that not only decrease implantation rates but also promote early abortions.

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“…We have sorted the factors causing infertility according to the presumed pathophysiology of the process involved (10). For example, we looked at the effects of endometriosis on endometrial proliferation, immune modulation, angiogenesis, and other mechanisms linked to the disease that are susceptible to alter the capacity to receive the embryo and permit the proper development (10)(11)(12)(13).…”

Section: Endometriosis and Early Pregnancy Losses: What Is The Evidence?mentioning

confidence: 99%

Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis

Pirtea

Cicinelli

Nola

et al. 2021

Fertility and Sterility

Self Cite

112

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Chronic inflammatory processes affecting the endometrium, as encountered in endometriosis, adenomyosis, and chronic endometritis, alter endometrial receptivity. These disorders are associated with early pregnancy losses and possibly recurrent pregnancy losses (RPL). In the cases of endometriosis, other factors associated with the disease also are susceptible of causing miscarriages and possibly RPL, such as an impact of intrapelvic inflammatory processes affecting the oocyte and embryo in case of natural conception. Conversely these latter effects obviously are bypassed in case of assisted reproductive technology. Chronic inflammation of the endometrium in the condition known as chronic endometritis also causes early pregnancy losses and RPL with beneficial effects achieved when specific treatment is undertaken. (Fertil Steril Ò 2021;115:546-60. Ó2020 by American Society for Reproductive Medicine.

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Assisted reproduction in endometriosis

Cited by 37 publications

References 72 publications

Early Pregnancy Outcomes in Fresh Versus Deferred Embryo Transfer Cycles for Endometriosis-Associated Infertility: A Retrospective Cohort Study

Early Pregnancy Outcomes in Fresh Versus Deferred Embryo Transfer Cycles for Endometriosis-Associated Infertility: A Retrospective Cohort Study

Pathogenesis of Endometriosis: The Origin of Pain and Subfertility

Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis

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