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Does Surgical Management of Endometriosis Within 6 Months of an In Vitro Fertilization–Embryo Transfer Cycle Improve Outcome?

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Abstract

Purpose : To assess the effect on cycle outcome of surgery for endometriosis performed in the 6 months prior to in vitro fertilization–embryo transfer (IVF-ET).

Methods : Retrospective analysis of all patients with a primary diagnosis of endometriosis undergoing IVF-ET during 12 consecutive months. The setting included tertiary care assisted reproductive technology program. Ninety-five consecutive cycles in candidates for autologous IVF-ET who had undergone surgical resection of endometriosis within 60 months of oocyte retrieval were evaluated. Five patients with persistent or recurrent endometriomas >3 cm at the time of IVF-ET were excluded. Patients were divided into two groups based on the interval between the most recent surgical intervention and oocyte aspiration—Group I: ≤6 months' interval (19 cycles); Group II: >6 months' interval (76 cycles).

Results : Mean intervals between surgery and oocyte aspiration were significantly different between the groups (Gr I: 3.7 ± 0.3 months; Gr II: 21.8 ± 1.6 months; p < 0.001). There were no significant differences between groups with regards to age, extent of endometriosis, or results of ovarian stimulation and oocyte aspiration. Ongoing pregnancy rates (Gr I: 63.2%; Gr. II: 60.5%) were similar. Regression analyses revealed no correlation between implantation rates and either endometriosis score (r = −0.09) or surgery–oocyte aspiration interval (r = −0.13).

Conclusions : The interval between surgical management of endometriosis and oocyte aspiration did not have an impact on IVF-ET cycle outcome in the absence of significant persistent or recurrent ovarian disease. Any effect of surgery on enhancing spontaneous conception may be overcome by the inherently greater impact of IVF-ET on implantation and pregnancy.

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Authors and Affiliations

  1. Colorado Center for Reproductive Medicine, Englewood, Colorado

    Eric S. Surrey & William B. Schoolcraft

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  1. Eric S. Surrey
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Surrey, E.S., Schoolcraft, W.B. Does Surgical Management of Endometriosis Within 6 Months of an In Vitro Fertilization–Embryo Transfer Cycle Improve Outcome?. J Assist Reprod Genet 20, 365–370 (2003). https://doi.org/10.1023/A:1025429027610

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  • DOI: https://doi.org/10.1023/A:1025429027610