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Does Surgical Management of Endometriosis Within 6 Months of an In Vitro Fertilization–Embryo Transfer Cycle Improve Outcome?

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Abstract

Purpose : To assess the effect on cycle outcome of surgery for endometriosis performed in the 6 months prior to in vitro fertilization–embryo transfer (IVF-ET).

Methods : Retrospective analysis of all patients with a primary diagnosis of endometriosis undergoing IVF-ET during 12 consecutive months. The setting included tertiary care assisted reproductive technology program. Ninety-five consecutive cycles in candidates for autologous IVF-ET who had undergone surgical resection of endometriosis within 60 months of oocyte retrieval were evaluated. Five patients with persistent or recurrent endometriomas >3 cm at the time of IVF-ET were excluded. Patients were divided into two groups based on the interval between the most recent surgical intervention and oocyte aspiration—Group I: ≤6 months' interval (19 cycles); Group II: >6 months' interval (76 cycles).

Results : Mean intervals between surgery and oocyte aspiration were significantly different between the groups (Gr I: 3.7 ± 0.3 months; Gr II: 21.8 ± 1.6 months; p < 0.001). There were no significant differences between groups with regards to age, extent of endometriosis, or results of ovarian stimulation and oocyte aspiration. Ongoing pregnancy rates (Gr I: 63.2%; Gr. II: 60.5%) were similar. Regression analyses revealed no correlation between implantation rates and either endometriosis score (r = −0.09) or surgery–oocyte aspiration interval (r = −0.13).

Conclusions : The interval between surgical management of endometriosis and oocyte aspiration did not have an impact on IVF-ET cycle outcome in the absence of significant persistent or recurrent ovarian disease. Any effect of surgery on enhancing spontaneous conception may be overcome by the inherently greater impact of IVF-ET on implantation and pregnancy.

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References

  1. Olivennes F, Feldberg D, Liu H-C, Cohen J, Moy F, Rosenwaks Z: Endometriosis: A stage by stage analysis—The role of in vitro fertilization. Fertil Steril 1995;64:392-398

    Google Scholar 

  2. Geber S, Paraschos T, Atkinson G, Margara R, Winston RML: Results of IVF in patients with endometriosis: The severity of the disease does not affect outcome, or the incidence of miscarriage. Hum Reprod 1995;10:1507-1511

    Google Scholar 

  3. Ryan IP, Taylor RN: Endometrosis and infertility: New concepts. Obstet Gynecol Surv 1997;52:365-371

    Google Scholar 

  4. Surrey ES, Halme J, Effect of peritoneal fluid from endometriosis patients on endometrial stromal cell proliferation in vitro. Obstet Gynecol 1990;76:792-797

    Google Scholar 

  5. Marcoux S, Maheux R, Berhle S, Canadian Collaborative Group on Endometriosis: Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med 1998;377:217-222

    Google Scholar 

  6. Candiani G, Vercillini P, Fedele L, Biandi S, Vendola N, Candiani M. Conservative surgical treatment for severe endometriosis in infertile women: Are we making progress? Obstet Gynecol Surv 1991;46:490-498

    Google Scholar 

  7. Adamson G, Pasta D. Surgical treatment of endometriosis-associated infertility: Meta-analysis compared with survival analysis. Am J Obstet Gynecol 1994;171:1488-1505

    Google Scholar 

  8. Miller K, Pittaway D, Deaton J: The effect of serum from infertile women with endometriosis on fertilization and early embryonic development in a murine in vitro fertilization model. Fertil Steril 1995;64:623-626

    Google Scholar 

  9. Surrey ES, Bower J, Hill D, Ramsey J, Surrey M: The clinical and endocrine effects of a microdose GnRH agonist flare regime administered to poor responder in vitro fertilization patients. Fertil Steril 1998;69:419-427

    Google Scholar 

  10. Gardner D, Schoolcraft W, Wagley L, Schlenker T, Stevens J, Hesla J: A prospective randomized trial of blastocyst culture and transfer in in vitro fertilization. Hum Reprod 1998;13:3434-3440

    Google Scholar 

  11. Schoolcraft WB, Surrey ES, Gardner DK. Embryo transfer: Techniques and variables affecting success. Fertil Steril 2001;76:863-870

    Google Scholar 

  12. The American Fertility Society. Revised American Fertility Society classification of endometriosis. Fertil Steril 1985;43:351-352

  13. Hughes EG, Fedorkow DM, Collins JA: A quantitative overview of controlled trials in endometriosis-associated infertility. Fertil Steril 1993;59:963-970

    Google Scholar 

  14. Gruppo Italiano por lo Studio dell Endometriosi. Ablation of lesions or no treatment in minimal-mild endometriosis in infertile women: A randomized trial. Hum Reprod 1999;14:1332-1334

  15. Surrey MW, Hill DL: Treatment of endometriosis by carbon dioxide laser during gamete intrafallopian transfer. J Am Coll Surg 1994;179:440-442

    Google Scholar 

  16. Diaz I, Navarro J, Blasco L, Simon C, Pellicer A, Remohi J: Impact of Stage III–IV endometriosis on recipients of sibling oocytes: Matched case-control study. Fertil Steril 2000;74:31-34

    Google Scholar 

  17. Azem F, Lessing JB, Geva E, Shahar A, Lerner-Geva L, Yovel I, Amit A: Patients with stages III and IV endometriosis have a poorer outcome of in vitro fertilization-embryo transfer than patients with tubal infertility. Fertil Steril 1999;72:1107-1109

    Google Scholar 

  18. Pal L, Shifren JL, Isaacson K, Chang YC, Leykin L, Toth TL: Impact of varying stages of endometriosis on the outcome of in vitro fertilization-embryo transfer. J Assist Reprod Genet 1998;15:27-31

    Google Scholar 

  19. Al-Azemi M, Lopez Bernal A, Steele J, Gramsbergen I, Barlow D, Kennedy S: Ovarian response to repeated controlled stimulation in in vitro fertilization cycles in patients with ovarian endometriosis. Hum Reprod 2000;15:72-75

    Google Scholar 

  20. Yanushpolsky E, Best C, Jackson K, Clarke R, Barbieri R, Hornstein M. Effects of endometriomas on oocyte quality, embryo quality and pregnancy rates in in vitro fertilization cycles: A prospective case-controlled study. J Assist Reprod Genet 1998;15:193-197

    Google Scholar 

  21. Surrey ES, Silverberg KM, Surrey MW, Schoolcraft WB. The effect of prolonged GnRH agonist therapy on in vitro fertilization-embryo transfer cycle outcome in endometriosis patients: A multicenter randomized trial. Fertil Steril 2002;78:699-704

    Google Scholar 

  22. Nakamura K, Oosawa M, Kondou I, Inagaki S, Shibata H, Narita O, Suganuma N, Tomoda Y: Menotropin stimulation after prolonged gonadotropin releasing hormone agonist pretreatment for in vitro fertilization in patients with endometriosis. J Assist Reprod Genet 1992;9:113-117

    Google Scholar 

  23. Dicker D, Goldman GA, Ashkenazi J, Feldberg D, Voliovitz I, Goldman JA: The value of pre-treatment with gonadotrophin releasing hormone (GnRH) analogue in IVF-ET therapy of severe endometriosis. Hum Reprod 1990;5:418-420

    Google Scholar 

  24. Marcus SF, Edwards RG: High rates of pregnancy after long-term down-regulation of women with severe endometriosis. Am J Obstet Gynecol 1994;171:812-817

    Google Scholar 

  25. Curtis P, Jackson A, Bernard A, Shaw RW: Pretreatment with gonadotrophin releasing hormone (GnRH) analogue prior to in vitro fertilization for patients with endometriosis. Eur J Obstet Gynecol Reprod Biol 1993;52:211-216

    Google Scholar 

  26. Lessey BA: Medical management of endometriosis and infertility. Fertil Steril 2000;73:1089-1096

    Google Scholar 

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Authors and Affiliations

  1. Colorado Center for Reproductive Medicine, Englewood, Colorado

    Eric S. Surrey & William B. Schoolcraft

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  1. Eric S. Surrey
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  2. William B. Schoolcraft
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Surrey, E.S., Schoolcraft, W.B. Does Surgical Management of Endometriosis Within 6 Months of an In Vitro Fertilization–Embryo Transfer Cycle Improve Outcome?. J Assist Reprod Genet 20, 365–370 (2003). https://doi.org/10.1023/A:1025429027610

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  • DOI: https://doi.org/10.1023/A:1025429027610

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