Jose María Puerta-Sanabria , Ana Clavero , María Carmen Gonzalvo , María Luisa López-Regalado , Bárbara Romero , Isabel Rodríguez , Juan Mozas , Juan Fontes , Luis Martínez , Andrea Pinto-Ibáñez , Silvia Copado , Jose Antonio Castilla
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Abstract
Introduction
Endometriosis is a disease characterised by the presence of endometrial cells outside the uterine cavity, leading to negative effects on the fertility of the woman. However, the mechanism whereby this occurs remains unclear.
Objective
A retrospective observational case-control study was conducted to compare the results of IVF/ICSI in women with endometriosis and male factor infertile couples, with the aim of finding evidence on the impact of endometriosis on the IVF/ICSI outcomes.
Material and methods
A study was carried out from 2009 to 2014, in which a total of 821 first cycles were performed on 156 patients with endometriosis, and 665 patients in whom the cause of infertility was due to pathology in their partner (male factor), and were considered as the control group. Ovarian stimulation parameters and IVF/ICSI outcomes were studied.
Results
Endometriosis patients required higher doses of FSH stimulation, subsequently yielding fewer oocytes and mature oocytes, although fertilisation rates were higher in these patients than in those with male factor. All cryopreservation parameters analysed were higher in male factor. No statistically significant results were obtained in other parameters analysed, such as the implantation rate, although the pregnancy and live birth rates analysed, especially the accumulated rate (fresh transfers + cryotransfers) were higher in all cases in the male factor, but without significance.
Discussion
This study suggests that endometriosis affects the success of IVF/ICSI by reducing the ovarian response to controlled stimulation, but neither oocyte quality nor endometrial receptivity are affected. It may be necessary to determine the factors that cause the decrease in ovarian follicle reserve, such as previous surgery, extent of disease, or previous drug treatments.