Abstract
Purpose: The effect of endometriomas on oocyte quality, embryo quality, and pregnancy rates in in vitro fertilization (IVF) cycles was evaluated.
Methods: Forty-five women had “chocolate” cysts aspirated at the time of oocyte retrieval, and cyst fluid CA 125 levels were measured to ascertain presence of “true” endometriomas. Fifty-seven women without any complex cysts at the time of oocyte retrieval served as controls. IVF cycle outcome parameters were compared between the two groups.
Results: Women with endometriomas experienced a significantly higher rate of early pregnancy loss compared to controls (47 vs 14%). There was also a trend toward fewer oocytes retrieved and fewer embryos reaching at least the four-cell stage 48 hr after retrieval in patients with true endometriomas vs controls.
Conclusions: The presence of endometriomas at the time of oocyte retrieval is associated with increased rates of early pregnancy losses. The number of oocytes retrieved and the embryo quality may also be affected adversely in the presence of endometriomas.
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REFERENCES
Mahmood TA, Templeton A: Prevalence and genesis of endometriosis. Hum Reprod 1991;6:544–549
Olive DL, Schwartz LB: Endometriosis. N Engl J Med 1993;328: 1759–1769
Paulson JD, Asmar P, Saffan DS: Mild and moderate endometriosis: Comparison of treatment modalities for infertile couples. J Reprod Med 1991;36:151–155
Marcoaux S, Maheux R, Berube S, et al.: Laparoscopic surgery in infertile women with minimal or mild endometriosis. N Engl J Med 1997;337:217–222
Mahmood TA, Templeton A: Pathophysiology of mild endometriosis: Review of literature. Hum Reprod 1990;5:765–784
Olive DL, Lee KL: Analysis of sequential treatment protocols for endometriosis-associated infertility. Am J Obstet Gynecol 1986;154:613–619
Telimaa S: Danazol and medroxyprogesterone acetate inefficatious in the treatment of infertility in endometriosis. Fertil Steril 1988;50:872–875
Matson PL, Yovich JL: The treatment of infertility associated with endometriosis by in vitro fertilization. Fertil Steril 1986;46:432–434
Yovich JL, Matson PL, Richardson PA, Hilliard C: Hormonal profiles and embryo quality in women with severe endometriosis treated by in vitro fertilization and embryo transfer. Fertil Steril 1988;50:308–313
Dlugi AM, Loy RA, Dieterle S, Bayer SR, Seibel MM: The effect of endometriomas on in vitro fertilization outcome. J In Vitro Fert Embryo Transfer 1989;6:338–341
Koninckx P, Muyldermans M, Moerman P, Mueleman C, Deprest J, Cornille F: CA 125 concentrations in ovarian “chocolate” cyst fluid can differentiate an endometriotic cyst from a cystic corpus luteum. Hum Reprod 1992;7:1314–1317
The American Fertility Society: Revised American Fertility Society classification of endometriosis. Fertil Steril 1985;43:351–352
Jackson KV, Nurredin A, Clarke RN, Hornstein MD, Rein MS, Friedman AJ: The appearance of one-pronuclear human oocytes is associated with better ovulation-induction response and successful pregnancy outcome. Fertil Steril 1992;58:366–372
Stewart EA, Jackson KV, Friedman AJ, Rein MS, Fox JH, Hornstein MD: The effect of baseline complex ovarian cysts on in vitro fertilization outcome. Fertil Steril 1992;57: 1274–1278
Dawson KJ, Conaghan J, Ostera GR, Winston RML, Hardy K: Delaying transfer to the third day post-insemination, to select non-arrested embryos, increases development to the fetal heart stage. Hum Reprod 1995;10:177–182
Grillo JM, Gamerre M, Lacroix O, Noizet A, Vitry G: Influence of the morphological aspect of embryos obtained by in vitro fertilization on their implantation rate. J In Vitro Fert Embryo Transfer 1991;8:317–321
Arici A, Oral E, Bukulmez O, Duleba A, Olive DL, Jones EE: The effect of endometriosis on implantation: Results from the Yale University in vitro fertilization and embryo transfer program. Fertil Steril 1996;65:603–607
Dicker D, Goldmlan GA, Ashkenazi J, Feldberg D, Voliovitz I, Goldman JA: The value of pretreatment with gonadotrophin releasing hormone (GnRH) analogue in IVF-ET therapy of severe endometriosis. Hum Reprod 1990;5:418–420
Sung L, Mukherjee T, Takeshige T, Bustillo M, Copperman AB: Endometriosis is not detrimental to embryo implantation in oocyte recipients. J Assist Reprod Genet 1997;14:152–156
Hornstein MD: Endometriosis and spontaneous abortion. In Recurrent Pregnancy Loss, Infertility and Reproductive Medicine, AJ Friedman (guest editor), Clinics of North America. Philadelphia, W. B. Saunders, 1991, pp. 175–185
Olivennes F, Feldberg D, Liu HC, Cohen J, Moy F, Rosenwaks Z: Endometriosis: A stage by stage analysis—The role of in vitro fertilization. Fertil Steril 1995;64:392–398
Penzias AS, Jones EE, Seifer DB, Grifo JA, Thatcher AA, DeCherney AH: Baseline ovarian cysts do not affect clinical response to controlled ovarian hyperstimulation. Fertil Steril 1992;57:1017–1021
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Yanushpolsky, E.H., Best, C.L., Jackson, K.V. et al. Effects of Endometriomas on Ooccyte Quality, Embryo Quality, and Pregnancy Rates in In Vitro Fertilization Cycles: A Prospective, Case-Controlled Study. J Assist Reprod Genet 15, 193–197 (1998). https://doi.org/10.1023/A:1023048318719
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DOI: https://doi.org/10.1023/A:1023048318719