Ovarian reserve markers and assisted reproductive technique (ART) outcomes in women with advanced endometriosis
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RESEARCH
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Ovarian reserve markers and assisted reproductive technique (ART) outcomes in women with advanced endometriosis Safiya A Wahd1*, Shahla K Alalaf1, Talha Al-Shawaf2,3 and Namir G Al-Tawil4
Abstract Background: The role of ovarian reserve markers as predictors of the controlled ovarian stimulation (COS) response in intracytoplasmic sperm injection (ICSI) cycles in women with endometriosis has been much debated. The aim of the present study is to assess the predictability of ovarian reserve markers for the number of mature oocytes (MII) retrieved and to assess the pregnancy rate and live birth rate in women with advanced endometriosis. Methods: Two hundred eighty-five infertile women who had laparoscopy followed by a first ICSI cycle were recruited in this prospective study. One hundred ten patients were diagnosed with endometriosis stage III-IV (group 1), and 175 patients had no endometriosis (group II). Sixty-three patients in group 1 had no history of previous endometrioma surgery (group Ia), and 47 patients had a history of previous endometrioma surgery (group Ib). Results: The number of mature oocytes retrieved was significantly lower in women with advanced endometriosis than in women with no endometriosis. The number of mature oocytes retrieved in women with and without endometriosis was best predicted by antral follicle count (AFC) and age, whereas only AFC was a predictor in women with previous endometrioma surgery (odds ratio: 0.49; 95% confidence interval: 0.13-0.60). Women with endometriosis had a lower rate of live births than the control group, but this difference was not statistically significant; the number of live births was significantly lower in those with previous endometrioma surgery. Conclusions: The best predictor of the COS response in ICSI was AFC, followed by age. Women receiving ICSI following surgery for ovarian endometrioma had a poorer clinical outcome and lower rate of live births compared with those with endometriosis but no previous surgery and the control group. Keywords: Stage III-IV endometriosis, Antral follicle count (AFC), Mature oocyte, Intracytoplasmic sperm injection (ICSI), Live birth rate
Background Endometriosis is benign but can be a debilitating gynecological disorder and commonly presents with pain and infertility [1]. The exact relationship between endometriosis and infertility remains unclear; surgical findings often do not correlate with fertility potential, nor do they predict therapeutic response [2]. Endometriosis is a common gynecological disorder that occurs in 6-10% of the female population and is more frequent (25-40%) in infertile women [3]. The reasons for this decreased * Correspondence: [email protected] 1 Department of Obstetrics and Gynecology, College of Medicine, Hawler Medical University, Erbil, Iraq Full list of author information is available at the end of the article
fertility in patients with endometriosis are unclear but may include anatomical distortion, the toxic influence of peritoneal fluid, decreased oocyte or emb
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