Skip to main content
SpringerLink
Log in

In vitro fertilization and embryo transfer (IVF/ET): An established and successful therapy for endometriosis

  • Special Contributions
  • Published:
Journal of in Vitro Fertilization and Embryo Transfer Aims and scope Submit manuscript

Abstract

The purpose of this report is to present a 6-year experience in the management of endometriosis with in vitro fertilization and embryo transfer (IVF/ET). We divided 136 patients who underwent 280 cycles into three groups: (1) previous history of endometriosis but normal pelvis at the time of oocyte retrieval, (2) stages I–II endometriosis (revised AFS classification), and (3) stages III–IV endometriosis. The stimulation protocols, estradiol (E2) responses, and distribution of terminal E2 patterns were similar in all groups. Group 3 had significantly fewer preovulatory and immature oocytes retrieved and fewer embryos transferred. The fertilization rate and the per cycle/per transfer pregnancy rates were similar in all groups. The miscarriage rate was higher in group 3, and the on-going pregnancy rate per cycle was lower, Luteal phase E2 and progesterone levels were comparable in all groups. No differences were found when groups 2 and 3 were analyzed for the presence of one or two ovaries or the presencelabsence of ovarian endometriosis. The overall fertilization rate, the per cycle/per transfer pregnancy rates, and the miscarriage rate were similar to those of tubal factor patients. We underscore the excellent out-come of patients with minimal or mild endometriosis in IVF/ET. We conclude that patients with moderate or severe endometriosis have a compromised reproductive potential, probably because of a reduced oocyte recovery rate and poor embryo quality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Olive DL, Haney AF: Endometriosis-associated infertility: A critical review of therapeutic approaches. Obstet Gynecol Surv 1986;47:538–555

    Google Scholar 

  2. Aral SO, Cates W Jr: The increasing concern with infertility: Why now? Science 1983;250:2327

    Google Scholar 

  3. Schmidt CL: Endometriosis: A reappraisal of pathogenesis and treatment. Fertil Steril 1985;44:157–173

    PubMed  Google Scholar 

  4. Mahadevan MM, Trounson AD, Leetou JF: The relationship of tubal blockage, infertility of unknown cause, suspected male infertility, and endometriosis to success of in vitro fertilization and embryo transfer. Fertil Steril 1983;40:755–762

    PubMed  Google Scholar 

  5. Chillik C, Acosta A, Garcia JE, Perera S, Van Uem JF, Rosenwaks Z, Jones HW Jr: The role of in vitro fertilization in infertile patients with endometriosis. Fertil Steril 1985; 44:56–61

    PubMed  Google Scholar 

  6. Wardle PG, Mitchell JD, McLaughlin EA, Ray BD, McDermott A, Hull MG: Endometriosis and ovulatory disorder: Reduced fertilization in vitro compared with tubal and unexplained infertility. Lancet 1985;2:236–239

    PubMed  Google Scholar 

  7. O'Shen RT, Chen C, Weiss T, Jones WR: Endometriosis and in vitro fertilization. Lancet 1985;2:723

    Google Scholar 

  8. Matson PL, Yovich JL: The treatment of infertility associated with endometriosis by in vitro fertilization. Fertil Steril 1986;46:432–434

    PubMed  Google Scholar 

  9. American Fertility Society: Revised classification of endometriosis: 1985. Fertil Steril 1985;43:351–352

    Google Scholar 

  10. Jones HW Jr, Acosta AA, Andrews MC, Garcia JE, Jones GS, Mayer J, Rosenwaks Z, Sandow B, Veeck L, Wilkes C: Three years of in vitro fertilization at Norfolk. Fertil Steril 1984; 42:826–834

    PubMed  Google Scholar 

  11. Rosenwaks Z, Muasher S, Acosta A: Use of hMG and/or FSH for multiple follicular development. Clin Obstet Gynecol 1986;29:148–157

    PubMed  Google Scholar 

  12. Veeck L, Maloney M: Insemination and fertilization.In In Vitro Fertilization-Norfolk, HW Jones, Jr, GS Jones, GD Hodgen, Z Rosenwaks (eds). Baltimore, Williams and Wilkins, 1986, pp 168–200

    Google Scholar 

  13. Veeck LL: Extracorporeal maturation: Norfolk. Ann NY Acad Sci 1985;774:357–367

    Google Scholar 

  14. Jones GS, Garcia JE, Rosenwaks Z: The role of pituitary gonadotropins in follicular stimulation and oocyte maturation in the human. JCEM 1984;59:178–180

    Google Scholar 

  15. Jones HW Jr, Acosta A, Andrews MC, Garcia JE, Jones GS, Mantzavinos T, McDowell J, Sandow B, Veeck L, Whibley T, Wilkes C, Wright G: The importance of the follicular phase to success and failure in IVF. Fertil Steril 1983: 40:317–321

    PubMed  Google Scholar 

  16. Jones HW Jr, Acosta A, Andrews MC, Garcia JE, Jones GS, Mantzavinos T, McDowell J, Sandow B, Veeck L, Whibley T, Wilkes C, Wright C: What is a pregnancy? A question for programs of in vitro fertilization. Fertil Steril 1983;40:728–733

    PubMed  Google Scholar 

  17. Navot D, Muasher S, Oehninger S, Liu HC, Veeck L, Kreiner D, Rosenwaks Z: The value of in vitro fertilization for the treatment of unexplained infertility. Fertil Steril 1988;49:854–857

    PubMed  Google Scholar 

  18. Yovich JL, Yovich JM, Tuvik AI, Matson PL, Wilcox DL: In vitro fertilization for endometriosis. Lancet 1985;2:552

    Google Scholar 

  19. Hargrove JT, Abraham CK: Abnormal luteal function in endometriosis. Fertil Steril 1980;34:302

    Google Scholar 

  20. Pittaway DE, Maxson W, daniell J, Herbert C, Wentz AC: Luteal phase defect in infertility patients with endometriosis. Fertil Steril 1983;39:712–713

    PubMed  Google Scholar 

  21. Muse K, Wilson EA, Jawad MJ: Prolactin hyperstimulation in response to thyrotropin-releasing hormone in patients with endometriosis. Fertil Steril 1982;38:419–422

    PubMed  Google Scholar 

  22. Ronnberg L, Kaupilla A, Rajaniemi H: Luteinizing hormone receptor disorder in endometriosis. Fertil Steril 1984 85;64–68

    Google Scholar 

  23. Brosens IA, Koninckx PR, Corveleyn PA: A study of plasma progesterone, estradiol 17-β, prolactin and LH levels, and of the appearance of the ovaries in patients with endometriosis and infertility. Br J Obstet Gynecol 1978; 85:246–250

    Google Scholar 

  24. Weed JC, Arquembourg PC: Endometriosis: Can it produce an autoimmune response resulting in infertility? Clin Obstet Gynecol 1980;23:885–893

    PubMed  Google Scholar 

  25. Dmowski WL, Steele RW, Baker GF: Deficient cellular immunity in endometriosis. Am J Obstet Gynecol 1981; 141:377–383

    PubMed  Google Scholar 

  26. Rock JA, Dubin NH, Ghodgaonbar RB, Bergquist CA, Erozan YS, Kimball AW Jr: Cul-de-sac fluid in women with endometriosis: Fluid volume and prostanoid concentration during the proliferative phase of the cycle—days 8 to 12 Fertil Steril 1982;37:747–750

    PubMed  Google Scholar 

  27. Drake TS, O'Brien WF, Ramwell PN, Metz SA: Peritoneal fluid thromboxane B2 and 6-keto-prostaglandin F1 alpha in endometriosis. Am J Obstet Gynecol 1981;140:401–404

    PubMed  Google Scholar 

  28. Haney AF, Muscato JI, Weinberg JF: Peritoneal cell populations in infertility patients. Fertil Steril 1981;35:696–698

    PubMed  Google Scholar 

  29. Fabih H, Bagget B, Holtz G, Tsang KY, Lee JC, Williamson HD: Interleukin-1: A possible role in the infertility associated with endometriosis. Fertil Steril 1987;47:213–217

    PubMed  Google Scholar 

  30. Hill JK, Haimovici F, Politch J, Anderson DJH: The effects of soluble products of activated lymphocytes and macrophages (lymphokines and monokines) on human sperm motion parameters. Fertil Steril 1987;47:460–465

    PubMed  Google Scholar 

  31. Morcos RN, Gibbons WE, Findley WE: Effect of peritoneal fluid on in vitro cleavage of 2-cell mouse embryos: Possible role in infertility associated with endometriosis. Fertil Steril 1985;44:678–683

    PubMed  Google Scholar 

  32. Sueldo C, Lambert H, Steinleitner A, Rathwick G, Swanson J: The effect of peritoneal fluid from patients with endometriosis on murine sperm-oocyte interaction. Fertil Steril 1987;48:697–699

    PubMed  Google Scholar 

  33. Chillik C, Rosenwaks C: Endometriosis and in vitro fertilization. Semin Reprod Endocrinol 1985:3:377–380

    Google Scholar 

  34. Oak MF, Vaughan CA, Elstein: The current status of infertility associated with pelvic endometriosis. Clin Reprod Fertil 1983;2:97

    PubMed  Google Scholar 

  35. Saifuddin A, Buckley CH, Fox H: Immunoglobulin content of the endometrium in women with endometriosis. Int J Gynecol Pathol 1983;2:255

    PubMed  Google Scholar 

  36. Kreiner D, Fromowitz F, Richardson D, Kenigsberg D: Endometrial immunofluorescence associated with endometriosis and pelvic inflammatory disease. Fertil Steril 1986: 46:243–246

    PubMed  Google Scholar 

  37. Groll M: Endometriosis and spontaneous abortion. Fertil Steril 1984;41:933–935

    PubMed  Google Scholar 

  38. Wheeler JM, Johnston BM, Malinak LR: The relationship of endometriosis to spontaneous abortion. Fertil Steril 1983;39:656–659

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, 825 Fairfax Avenue, 23507, Norfolk, Virginia

    Sergio Oehninger, anibal A. Acosta, David Kreiner, Suheil J. Muasher, Howard W. Jones Jr. & Zev Rosenwaks

Authors
  1. Sergio Oehninger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. anibal A. Acosta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Kreiner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Suheil J. Muasher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Howard W. Jones Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Zev Rosenwaks
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oehninger, S., Acosta, a.A., Kreiner, D. et al. In vitro fertilization and embryo transfer (IVF/ET): An established and successful therapy for endometriosis. J Assist Reprod Genet 5, 249–256 (1988). https://doi.org/10.1007/BF01132172

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01132172

Key Words

Search

Navigation