Ovarian Endometrioma Reduces the Chance of a Successful Pregnancy With IVF

Ovarian Endometrioma Decreases Ovarian Reserve and Reduces the efficacy of IVF, a new study reported.

Key Points

Highlights: 

• Ovarian endometrioma reduces ovarian function and reduces the efficacy of IVF.

Importance:

• Patients with ovarian endometrioma wishing to conceive should keep this information for appropriate decision-making.

What's done here:

• A five-year retrospective cohort study on 619 patients with endometriosis undergoing IVF and embryo transfer.

Key results:

• The numbers of oocytes and 2-pronuclei embryos are lower in women with pelvic endometriosis who also have ovarian endometrioma compared to those who only have pelvic endometriosis. 
• IVF outcome is significantly correlated with the number of resting follicles, basal levels of follicle-stimulating hormone, and the number of oocytes, 2-pronuclei embryos, and 2-pronuclei high-quality embryos.
• The number of 2-pronuclei high-quality embryos is the only independent predictive factor of IVF outcome.

Limitations:

• The study did not take into account the relationship between the stage of endometriosis and IVF outcome.

Lay Summary

Ovarian endometrioma significantly decreases ovarian reserve or the capacity of the ovaries to produce eggs that are able to be fertilized and give rise to a successful pregnancy. This is according to a study published in the scientific journal Medicine. This ultimately affects the efficacy of in vitro fertilization (IVF) and embryo transfer.

The authors of the study also reported that obtaining more 2-pronuclei high-quality embryos was important for IVF embryo transfer treatment in young women with ovarian endometriomas.

In order to compare the ovarian reserve and IVF outcomes in young patients with pelvic endometriosis with or without ovarian endometrioma, a team of researchers from the Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Shaw Hospital, Zhejiang University School of Medicine in Hangzhou, China conducted a five-year retrospective cohort study.

For the study, the researchers analyzed 619 patients ages 38 and younger who underwent IVF- embryo transfer between January 2011 and December 2015. Of these 619 patients, more than half (398) had pelvic endometriosis with ovarian endometrioma while 398 had pelvic endometriosis without ovarian endometrioma. 

The results showed that the numbers of oocytes and 2-pronuclei embryos, the first sign of successful fertilization in all age groups, and the number of 2-pronuclei high-quality embryos in patients younger than age 30 was lower when ovarian endometrioma was present.

Statistical analyses showed that successful IVF outcome was significantly correlated with factors such as the number of resting egg follicles, basal levels of follicle-stimulating hormone, the number of oocytes, the number of  2-pronuclei embryos, and the number of 2-pronuclei high-quality embryos. Of these factors, the only independent predictive factor was the number of 2-pronuclei high-quality embryos.

“ (…) ovarian endometrioma can significantly reduce ovarian function in young patients and affect the treatment outcomes of IVF-[embryo transfer],” the authors concluded.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35777051/