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J Minim Invasive Gynecol. 2018 Jan;25(1):99-104. doi: 10.1016/j.jmig.2017.08.641. Epub 2017 Aug 12.

In Vitro Fertilization Success Rates after Surgically Treated Endometriosis and Effect of Time Interval between Surgery and In Vitro Fertilization.

Author information

1
CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
2
CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: itaigatmd@gmail.com.
3
CReATe Fertility Centre, Toronto, Ontario, Canada.
4
CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada.

Abstract

STUDY OBJECTIVE:

To evaluate the impact of endometriosis staging and endometriomas on in vitro fertilization (IVF) outcome and to assess the optimal time interval between laparoscopy and IVF.

DESIGN:

A retrospective clinical study (Canadian Task Force classification II1).

SETTING:

A university-affiliated private infertility clinic.

PATIENTS:

Two hundred sixteen infertile patients with endometriosis and 209 infertile patients without endometriosis.

INTERVENTIONS:

Laparoscopy, IVF.

MEASUREMENTS AND MAIN RESULTS:

Patients with endometriosis were classified according to American Society for Reproductive Medicine criteria; 58, 67, 63, and 28 patients had stages 1 through 4 disease, respectively. Patients with endometriosis had significantly lower estradiol on trigger day (9986 ± 6710 vs 12 220 ± 9414 pg/mL, respectively) and number of retrieved oocytes (12.7 ± 8.6 vs 14.0 ± 10, respectively) compared with controls. We found a consistent decline in clinical and ongoing pregnancy rates with increasing stage of endometriosis. The presence of endometrioma in patients with stages 3 and 4 endometriosis did not alter IVF outcome. Patients with a time interval of 7 to 12 and 13 to 25 months after surgery had a favorable outcome.

CONCLUSION:

IVF pregnancy rate was negatively correlated with endometriosis severity. The presence of endometriomas had no impact on IVF clinical outcome. The optimal time to perform IVF appears to be between 7 and 25 months after endometriosis surgery.

KEYWORDS:

Endometriosis; In vitro fertilization; Infertility; Laparoscopy; Pregnancy rate

PMID:
28807807
DOI:
10.1016/j.jmig.2017.08.641

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