Ovarian stimulation and endometriosis progression or recurrence: a systematic review

Somigliana, Edgardo; Viganò, Paola; Benaglia, Laura; Busnelli, Andrea; Paffoni, Alessio; Vercellini, Paolo

doi:10.1016/j.rbmo.2018.11.021

Cited by 43 publications

(25 citation statements)

References 49 publications

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“…The impact of IVF on an endometriotic cyst seems to be mild. In their systematic review, Somigliana et al reported that IVF does not worsen endometriosis-related pain symptoms or increase the risk of endometriosis recurrence [42].…”

Section: Discussionmentioning

confidence: 99%

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

et al. 2020

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Objective To examine the impact of ethanol sclerotherapy (EST) for endometrioma on in vitro fertilization (IVF) cumulative live birth rates (CLBR) in women with moderate-severe endometriosis. Methods This retrospective cohort study included women with moderate-severe endometriosis (revised American Fertility Society stage III-IV) and endometrioma who underwent IVF with the ultra-long agonist protocol. We compared two groups: women undergoing EST for endometrioma before IVF (EST group), and women whose endometrioma was left in situ during IVF (No-EST group). The primary outcome was the CLBR per IVF cycle, including fresh and frozen embryo transfers. The secondary endpoints included the complication rate, number of mature oocytes retrieved, clinical pregnancy rate and pregnancy loss rate. Results Seventy-four women were included in the study, with 37 in the EST group and 37 in the No-EST group, representing 67 and 69 IVF cycles, respectively. The population and cycle characteristics were comparable between the two groups, especially the ovarian response to stimulation. The CLBR was significantly increased in the EST group compared to the No-EST group (31.3% vs. 14.5%, p = 0.03). The clinical and biochemical pregnancy rates were significantly increased in the EST group (37.3% vs. 15.9%, p = 0.01 and 43.3% vs. 23.2%, p = 0.01, respectively). Multivariate analysis revealed a significantly increased chance of live birth in women exposed to EST before IVF with an adjusted OR of 2.68 (95% confidence interval, CI: 1.13-6.36, p = 0.02). In the EST group, we reported one major complication Clavien and Dindo classification grade III, complication involving an ovarian abscess that required a laparoscopic drainage.

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Section: Discussionmentioning

confidence: 99%

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

et al. 2020

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“…However, ovarian stimulation may cause some concerns among patients. Impact of ovarian stimulation on the progression of endometriosis or its recurrence was recently summarized in a systematic review [ 24 ]. According to their report, impact of ovarian stimulation on ovarian endometrioma, if present, is clinically unremarkable.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intrauterine insemination in women with endometrioma-associated subfertility: analysis using propensity score matching

Cai

Xie

Shi

et al. 2022

BMC Pregnancy Childbirth

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Background Intrauterine insemination (IUI) treatment is recommended in subfertile women with AFS/ASRM stage I/II endometriosis. However, the efficacy of IUI in women with ovarian endometriomas with tubal patency is uncertain. We explored the efficacy of IUI for the treatment of endometrioma-associated subfertility. Methods We performed a retrospective matched cohort study using propensity matching (PSM) analysis. Subfertile couples undergoing IUI with and without ovarian stimulation between January 1, 2015, and May 30, 2020 were reviewed. Results After PSM, 56 women with endometrioma alone were matched to 173 patients with unexplained subfertility. The per-cycle pregnancy rate (PR) was comparable between women with endometrioma-associated subfertility (n = 56, 87 cycles) and women with unexplained subfertility (n = 173, 280 cycles) (9.2% vs. 17.9%, OR 0.47; 95% CI, 0.21–1.03). Subgroup analyses based on IUI with or without stimulation also resulted in comparable results. A trend toward a lower cumulative pregnancy rates (CPRs) was seen in women with endometrioma (14.3%, 8/56) compared with women with unexplained subfertility (28.9%, 50/173), but the differences were not significant (HR 0.49; 95% CI, 0.23–1.15). However, patients with endometrioma were nearly twice as likely to converse to IVF treatment compared with those without the disease (60.7% versus 43.9%; OR 1.97; 95% CI, 1.07–3.65). Conclusion IUI may be a viable approach for subfertile women with endometrioma and no other identifiable infertility factor. More studies are needed to reassure the findings.

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“…Возможно, гормональная супрессия ведет к неполному удалению эндометриоидных очагов во время оперативного вмешательства, вызывая их атрофию и уменьшая в размерах [29]. Противоречивые данные имеются относительно связи рецидива ЭКЯ с предшествующим использованием препаратов для стимуляции яичников в программах ВРТ [30][31].…”

Section: факторы риска развития рецидива экяunclassified

Ovarian Endometriosis: The Modern Possibilities of Relapse Prediction

Оразов

Abitova

Хамошина

et al. 2020

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Ovarian stimulation and endometriosis progression or recurrence: a systematic review

Cited by 43 publications

References 49 publications

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

Endometrioma ethanol sclerotherapy could increase IVF live birth rate in women with moderate-severe endometriosis

Efficacy of intrauterine insemination in women with endometrioma-associated subfertility: analysis using propensity score matching

Ovarian Endometriosis: The Modern Possibilities of Relapse Prediction

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