The impact of endometriosis on in vitro fertilization outcome

Introduction: Nowadays, endometriosis represents the most frequent cause of female infertility.The treatment of choice is by all means laparoscopic surgery, which results in more than a 60 % pregnancy rate, regardless of the stage of the disease. For the rest of patients in vitro fertilization (IVF) is the most appropriate treatment of choice. Views of the impact of endometriosis on IVF outcome remain controversial and subject to debate. Whereas some studies have documented that endometriosis is associated with reduced pregnancy rates, others failed to prove this association. The present study was designed to elucidate whether or not endometriosis affects IVF outcome at our institution. The study was retrospective, statistical significance was considered at p ≤ 0.05. Methods: In 96 patients (group A) that underwent IVF program the only cause of infertility was endometriosis which had been previously treated surgically. Sixty-two (64.6 %) patients had minimal or mild endometriosis (group C) and 34 (35.4 %) had moderate or severe stage of the disease (group D). The control group (group B) consisted of 305 patients who underwent IVF procedure for tubal or idiopathic infertility. Among other variables, pregnancy rate per cycle and per embryo transfer (ET), take-home-baby rate (THBR) per cycle and per ET were compared between the study and control groups of patients as well as between both groups with endometriosis. The study was retrospective. Statistical significance was defined as p ≤ 0.05. Results: No statistically significant differences were found in any of the compared parameters. In Group “A” pregnancy rate per cycle and per ET was 41.7 % and 46.8 % respectively, compared to Group “B” where it was 36.4 % and 40.5 % respectively. THBR per cycle and per ET in Group “A” was 35.4 % and 43.0 %, whereas in the control group it was 30.5 % and 33.9 % respectively. Pregnancy rate per cycle and per ET in Group “C” was 40.3 % and 48.1 % whereas in Group “D” it was 44.1 % and 55.6 % respectively. THBR per cycle and per ET in Group “C” was 33.9 % and 40.4 % whereas in Group “D” it was 38.2 % and 48.1 % respectively. Conclusions: Endometriosis does not affect the outcome of IVF procedures. We believe that appropriate surgical technique is of paramount importance in patients with endometriosis, leading to favourable IVF outcomes.