Having Endometriosis Surgery After IVF Better, Study Suggests

Endometriosis surgery followed by IVF is associated with more top-quality blastocysts

Key Points

Highlights: 

• Performing endometrioma surgery after IVF is associated with better outcomes

Importance:

• This study can help guide decision-making regarding the order in which the two treatments are performed.

What’s done here:

• This is a retrospective cross-sectional controlled study in 279 women with endometriosis, of whom 89 with endometrioma underwent IVF treatment.

Key results:

• The rate of clinical pregnancy was comparable between women who underwent endometrioma surgery first and those who underwent IVF first.
• When IVF was performed first, patients had a higher number of top-quality embryos.

Limitations:

• Women who had irregular periods and those with hydrosalpinx were not excluded from the study.
• The levels of anti-Mullerian hormone in patients who underwent endometriosis surgery first were measured after the operation.

Lay Summary

A new study published in Archives of Gynecology and Obstetrics suggests that performing in vitro fertilization (IVF) before surgery may lead to better IVF outcomes for women with endometrioma.

To determine the optimal treatment sequence, Dr. Ivan Sini and colleagues from Morula IVF Jakarta Clinic conducted a retrospective cross-sectional study involving 279 women with endometriosis between January 2018 and December 2022. Among them, 86 women with ovarian endometriomas underwent IVF treatment.

The study compared three groups: a)Women who underwent IVF followed by surgery (40 patients), b) Women who had surgery before IVF (48 patients), and c) Women who had IVF without surgery.

Of these patients, 86 who had endometrioma took part in an IVF program. 

The clinical pregnancy rate—defined as a pregnancy confirmed by ultrasound detection of a gestational sac or fetal heartbeat—was similar across all three groups. However, the number of top-quality blastocysts was significantly higher in the group that received IVF before surgery.

Based on these findings, the authors conclude that IVF followed by endometriosis surgery may be a more effective strategy for patients with endometrioma, potentially optimizing embryo quality and overall fertility outcomes.

“Our study suggests that opting for IVF prior to endometriosis removal surgery may result in a more favorable IVF outcome,” the researchers noted.

Research Source: https://pubmed.ncbi.nlm.nih.gov/40044926