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Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis

  • Assisted Reproduction Technologies
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Abstract

Purpose

To assess the factors associated with a poor prognosis for a cumulative IVF live birth rate (LBR) in women with stage III and IV endometriosis according to the revised classification of the American Fertility Society (rAFS).

Methods

A retrospective cohort study was conducted between January 1, 2010, and December 31, 2014, in our Reproductive Medicine Center. We analyzed different factors associated with a poor prognosis for a cumulative IVF LBR in women with rAFS stage III and IV endometriosis. A total of 101 patients were included, representing 232 IVF-ICSI cycles and 212 embryo transfers. The primary endpoint was the cumulative LBR per cycle and per patient.

Results

The cumulative LBR per cycle was 14.7% (n = 34) and that per patient was 31.7% (n = 32). The cumulative LBR was significantly decreased by active smoking [adjOR = 3.4, 95% CI (1.12–10.60), p = 0.031], poor ovarian response (POR) according to the Bologna criteria [adjOR = 11.5, 95% CI (1.37–96.83), p = 0.024], and rAFS stage IV [adjOR = 3.2, 95% CI (1.13–8.95), p = 0.024]. The cumulative LBR per women was 59.4% without factors associated with a poor prognosis and 25.6% in the case of one factor, and it decreased to 7.7% in the case of two or three factors (p < 0.001).

Conclusion

Active smoking, POR according to the Bologna criteria, and rAFS stage IV endometriosis had a negative impact on the IVF-ICSI cumulative LBR for women with rAFS stage III and IV endometriosis. Because smoking dramatically decreases the LBR with endometriosis, stopping smoking before IVF-ICSI should be strongly advised.

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Authors and Affiliations

  1. Department of Women, Parents and Children, Clinico-Biological Center for Assisted Reproductive Technology - CECOS, AP-HM La Conception, 147 bd Baille, 13005, Marseille, France

    Pauline Roux, Jeanne Perrin, Aubert Agostini, Léon Boubli & Blandine Courbiere

  2. Aix-Marseille Université, CNRS, IRD, |, Avignon Université, IMBE UMR 7263, 13397, Marseille, France

    Jeanne Perrin & Blandine Courbiere

  3. Department of Biostatistics, AP-HM, Hôpital de la Timone, BiosTIC, 264 rue Saint-Pierre, 13385, Marseille, France

    Julien Mancini

  4. Aix Marseille Université, INSERM, IRD, UMR912 SESSTIM, Marseille, France

    Julien Mancini

Authors
  1. Pauline Roux
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  2. Jeanne Perrin
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  3. Julien Mancini
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  4. Aubert Agostini
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  5. Léon Boubli
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  6. Blandine Courbiere
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Corresponding author

Correspondence to Pauline Roux.

Ethics declarations

This study was approved by The French Ethical Committee of Research in Obstetrics and Gynecology (CEROG 2015-GYN-0503).

Conflict of interest

None declared.

Funding

None declared.

Ethical approval

All of the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Ethics statement

This study was approved by The French Ethical Committee of Research in Obstetrics and Gynecology (CEROG 2015-GYN-0503).

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Roux, P., Perrin, J., Mancini, J. et al. Factors associated with a poor prognosis for the IVF-ICSI live birth rate in women with rAFS stage III and IV endometriosis. J Assist Reprod Genet 34, 921–928 (2017). https://doi.org/10.1007/s10815-017-0943-1

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  • DOI: https://doi.org/10.1007/s10815-017-0943-1

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