Abstract
Objective To investigate the IVF outcome for patients with endometriosis.
Setting Academic research center.
PATIENT(S): A MEDLINE search and review of the literature were performed. Patients were classified by level of endometriosis, and controls were classified according to the indication for IVF.
INTERVENTION(S): Bivariate analysis and multivariate logistic regression was used to estimate overall effect and control for confounding.
MAIN OUTCOME MEASURE(S): Pregnancy rates, fertilization rate, implantation rates, and numbers of oocytes retrieved.
RESULT(S): Twenty-two published studies were included in the overall analysis. The chance of achieving pregnancy was significantly lower for endometriosis patients (odds ratio, 0.56; 95% confidence interval, 0.44-0.70) when compared with tubal factor controls. Multivariate analysis also demonstrated a decrease in fertilization and implantation rates, and a significant decrease in the number of oocytes retrieved for endometriosis patients. Pregnancy rates for women with severe endometriosis were significantly lower than for women with mild disease (odds ratio, 0.60; 95% confidence interval, 0.42-0.87).
CONCLUSION(S): Patients with endometriosis-associated infertility undergoing IVF respond with significantly decreased levels of all markers of reproductive process, resulting in a pregnancy rate that is almost one half that of women with other indications for IVF. These data suggest that the effect of endometriosis is not exclusively on the receptivity of the endometrium but also on the development of the oocyte and embryo.
endometriosis IVF pregnancy rate meta-analysis, endometriosis associated infertility in vitro fertilization outcomes, severe endometriosis oocyte retrieval fertilization implantation rates, Barnhart endometriosis IVF meta-analysis, endometriosis effect oocyte quality embryo development, endometriosis versus tubal factor IVF pregnancy outcomes, endometriosis endometrial receptivity oocyte impairment, mild versus severe endometriosis IVF success rates, meta-analysis assisted reproduction endometriosis infertility, endometriosis IVF implantation failure multivariate analysis
PMID 12057720 12057720 DOI 10.1016/s0015-0282(02)03112-6 10.1016/s0015-0282(02)03112-6
Keywords
Adult, Cell Count, Embryo Implantation, Endometriosis/physiopathology, Female, Fertilization, Fertilization in Vitro, Humans, Oocytes/cytology, Pregnancy, Pregnancy Rate, Severity of Illness Index, Tissue and Organ Harvesting