Influence of Endometriosis on Assisted Reproductive Technology Outcomes

Hamdan, Mukhri; Omar, Siti Zawiah; Dunselman, G.A.J.; Cheong, Ying

doi:10.1097/aog.0000000000000592

Cited by 133 publications

(97 citation statements)

References 69 publications

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“…A recent two meta-analysis have focused on the OS characteristics and ART outcomes of women with intact endometriomas (6,24). According to Hamdan et al, women with intact endometrioma revealed lower number of retrieved oocytes when compared to women with no endometriosis (SMD -0.23; 95% CI (-0.37, -0.10) (6). Similarly, pooled data from the meta-analysis of Yang et al revealed 1.50 fewer oocytes retrieved in women with ovarian endometrioma than in those without endometrioma (WMD -1.50; 95% CI -2.84 to -0.15, P=0.03) (24).…”

Section: Discussionmentioning

confidence: 99%

“…In those studies, endometrioma cases were compared to that of other infertility etiologies including male or tubal factor infertility (8,(21)(22)(23). A recent two meta-analysis have focused on the OS characteristics and ART outcomes of women with intact endometriomas (6,24). According to Hamdan et al, women with intact endometrioma revealed lower number of retrieved oocytes when compared to women with no endometriosis (SMD -0.23; 95% CI (-0.37, -0.10) (6).…”

Section: Discussionmentioning

confidence: 99%

“…A staging system (American Society of Reproductive Medicine Endometriosis Classification) is currently being used to document the severity of the condition and to counsel patients as well (4). Accumulating evidence suggests that advanced stage disease (III-IV) is associated with poorer reproductive outcomes when compared to earlier stages in women undergoing assisted reproductive technologies (ART) (5,6). Advanced stage endometriosis may exist in several forms and is rather a heterogeneous group.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

Pabuçcu

Gürsoy

Ulubaşoğlu

et al. 2016

Gynecol Obstet Reprod Med

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OBJECTIVE:To compare oocyte yield of women with intact ovarian endometrioma(s) to those without endometrioma undergoing ART. Secondary outcomes were implantation and live birth rates between the two groups. STUDY DESIGN:Retrospective case-control study was conducted to document eligible cases. A total of 165 women with intact endometrioma(s) (END) were included in the final analysis. Total of 196 cases with tubal factor infertility who underwent ART in the same time period were included as controls (CONT group). Cases and controls were matched for age, BMI and serum AMH concentrations. Ovarian stimulation characteristics and pregnancy outcomes including live birth data were documented for both groups. RESULTS:Despite similar demographic characteristics, significantly longer cycle duration and higher amounts of gonadotropin consumption was observed in END group compared to controls (p<0.001). Significantly lower number of retrieved oocytes, mature oocytes and mature oocyte fraction (%, no of retrieved/mature) were detected in END group. There was no statistically significant difference in terms of fertilization, implantation and live birth rate per started cycle among groups. Cycle cancellations were also similar. CONCLUSION:In women with intact ovarian endometrioma(s) undergoing ART, oocyte quantity, especially mature oocyte yield was hampered. However, adequate number of mature oocytes, successful fertilization and satisfactory implantation rates might be possible contributing to acceptable live births. Further randomized controlled trials of patients with different sizes of endometrioma(s) would be needed to confirm our conclusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

Pabuçcu

Gürsoy

Ulubaşoğlu

et al. 2016

Gynecol Obstet Reprod Med

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“…Notably, it is also present in 20-40% of women undergoing IVF and is often associated with lower rates of live births, clinical pregnancy and implantation rates [3][4][5]. Women with Stage III and IV endometriosis can develop endometriomas, or cysts arising from ectopic endometrial tissue implanted in the ovary with invagination of the ovarian cortex.…”

Section: Introductionmentioning

confidence: 99%

“…In the setting of IVF, endometriomas can make oocyte aspiration difficult due to limited visualization of the follicular cohort [6,7]. As a result, clinicians often obtain a lower yield of oocytes [4]. In addition, there is an increased risk of inadvertent fenestration of the endometrioma, which has been shown to cause inflammatory peritonitis, and if aspirated into the egg retrieval needle, can be detrimental to the oocyte [8].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2015

OGIJ

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Objective: Evaluate whether transvaginal aspiration of endometriomas with saline or ethanol sclerosis improves ovarian response and IVF outcomes.Design: This was a randomized controlled trial of 22 women undergoing IVF at a university-affiliated infertility clinic, 1998-2002. Subjects, aged 18-42 with body mass index (BMI, kg/m 2 ) less than 40 and adequate ovarian reserve, had undergone laparoscopic cystectomy for an endometrioma within 12 months followed by an unsuccessful IVF cycle with recurrence on imaging. Ten subjects were randomized to cyst aspiration with saline (control) and 12 to 95% ethanol, followed by another IVF cycle. The main outcomes were ovarian response and IVF outcomes pre-and post-endometrioma aspiration.Results: There was a higher median peak estradiol level post-aspiration (2598 pg/ml vs. 2107pg/ml, p = 0.04) and a greater increase in the median number of oocytes retrieved during the post-aspiration IVF cycle compared to the preaspiration cycle (3 vs. 2, p = 0.04) in the ethanol versus saline group. Conclusion:Ethanol sclerosis leads to a higher peak estradiol level and a greater increase in the number of oocytes retrieved from initial to post-aspiration IVF cycle compared to saline. In women with recurrent endometriomas attempting IVF, ethanol sclerosis is a minimally invasive alternative to surgery.

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Managing endometrioma to optimize future fertility

Horan

Glover

Wingfield

2021

Intl J Gynecology & Obste

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The management of endometriomas in women wishing to preserve their fertility is complex. While surgery can help to achieve pregnancy in some, it may also have a detrimental effect on a woman's ovarian reserve. The present article reviews the impact of endometriomas on fertility and the different management approaches that should be considered in women who wish to preserve their fertility. This study also reviews the role of assisted reproduction in the setting of endometriomas, and the evolving role of oocyte cryopreservation for this benign but progressive disease. Using evidence from the latest guidelines and major publications, we emphasize the need to consider the woman's future fertility when navigating the diverse range of management strategies available, and outline an evidence‐based framework to help facilitate fertility‐friendly discussion, counseling and management of this complex disease.

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Influence of Endometriosis on Assisted Reproductive Technology Outcomes

Abstract: Women with and without endometriosis have comparable ART outcomes in terms of live births, whereas those with severe endometriosis have inferior outcomes. There is insufficient evidence to recommend surgery routinely before undergoing ART.

Cited by 133 publications

References 69 publications

The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

The Impact of Ovarian Endometrioma(s) on ART Outcomes: Retrospective Case Control Study

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Managing endometrioma to optimize future fertility

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