Abstract
Purpose
To investigate the hypothesis that surgical treatment of endometriosis in infertile patients may improve pregnancy rates by improving embryo quality.
Methods
We conducted a retrospective evaluation of 30 infertile patients treated with in vitro fertilization (IVF) before and after surgery for endometriosis. Patients served as their own controls and only cycles with similar stimulation protocols were compared.
Results
Using standard visual evaluation, embryo quality on day 3 was similar before and after surgical treatment of endometriosis. Fifty seven percent of patients had stage I–II endometriosis and 43% had stage III–IV disease. No patients had a live birth after the first IVF cycle and 43% of patients had a live birth with the IVF cycle after surgery.
Conclusions
Surgical treatment of endometriosis does not alter embryo quality in patients with infertility treated with IVF.
Similar content being viewed by others
References
D’Hooghe TM, Debrock S, Hill JA, Meuleman C. Endometriosis and subfertility: is the relationship resolved? Semin Reprod Med 2003;21(2):243–54. doi:10.1055/s-2003-41330.
Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril 2002;77(6):1148–55. doi:10.1016/S0015-0282(02)03112-6.
Kennedy S, Bergqvist A, Chapron C, D’Hooghe T, Dunselman G, Greb R. ESHRE special interest group for endometriosis and endometrium guideline development group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 2005;20:2698–704. doi:10.1093/humrep/dei135.
Marcoux S, Maheux R, Bérubé S. Laparoscopic surgery in infertile women with minimal or mild endometriosis. Canadian Collaborative Group on Endometriosis. N Engl J Med 1997;337(4):217–22. doi:10.1056/NEJM199707243370401.
Fuchs F, Raynal P, Salama S, Guillot E, Le Tohic A, Chis C, et al. J Gynecol Obstet Biol Reprod (Paris). 2007;36(4):354–9.
Littman E, Giudice L, Lathi R, Berker B, Milki A, Nezhat C. Role of laparoscopic treatment of endometriosis in patients with failed in vitro fertilization cycles. Fertil Steril 2005;84(6):1574–8. doi:10.1016/j.fertnstert.2005.02.059.
Jun SH, Choi B, Shahine L, Westphal LM, Behr B, Reijo Pera RA. Defining human embryo phenotypes by cohort-specific prognostic factors. PLoS One 2008;3(7):e2562. doi:10.1371/journal.pone.0002562.
Veeck L. An atlas of human gametes and conceptuses. New York: Parthenon; 1999. p. 47–50.
Gardner DK, Schoolcraft WB. In-vitro culture of human blastocysts. In: Jansen R, Mortimer D, editors. Towards reproductive certainty: fertility and genetics beyond 1999. Carnforth: Parthenon; 1999. p. 378–88.
Behr B, Gebhardt J, Lyon J, Milki AA. Factors relating to a successful cryopreserved blastocyst transfer program. Fertil Steril 2002;77:697–9. doi:10.1016/S0015-0282(01)03267-8.
Schenken RS, Guzick DS. Revised endometriosis classification: 1996. Fertil Steril 1997;67(5):815–6. doi:10.1016/S0015-0282(97)81390-8.
Milki AA, Hinckley MD, Gebhardt J, Dasig D, Westphal LM, Behr B. Accuracy of day 3 criteria for selecting the best embryos. Fertil Steril 2002;77(6):1191–5. doi:10.1016/S0015-0282(02)03104-7.
Mahadevan MM, Trounson AO, Leeton JF. The relationship of tubal blockage, infertility of unknown cause, suspected male infertility, and endometriosis to success of in vitro fertilization and embryo transfer. Fertil Steril 1983;40(6):755–62.
Simón C, Gutiérrez A, Vidal A, de los Santos MJ, Tarín JJ, Remohí J. Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation. Hum Reprod 1994;9(4):725–9.
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(3):603–7.
Lessey BA, et al. Aberrant integrin expression in the endometrium of women with endometriosis. J Clin Endocrinol Metab 1994;79:643–9. doi:10.1210/jc.79.2.643.
Taylor HS, Arici A, Olive D, Igarashi P. HOXA10 is expressed in response to sex steroids at the time of implantation in the human endometrium. J Clin Invest 1998;101(7):1379–84.
Dmowski WP, Ding J, Shen J, Rana N, Fernandez BB, Braun DP. Apoptosis in endometrial glandular and stromal cells in women with and without endometriosis. Hum Reprod 2001;16(9):1802–8. doi:10.1093/humrep/16.9.1802.
Burney RO, Talbi S, Hamilton AE, Vo KC, Nyegaard M, Nezhat CR. Gene expression analysis of endometrium reveals progesterone resistance and candidate susceptibility genes in women with endometriosis. Endocrinology 2007;148(8):3814–26. doi:10.1210/en.2006-1692.
Author information
Authors and Affiliations
Corresponding author
Additional information
Capsule Surgical treatment of endometriosis did not alter embryo quality in patients undergoing in vitro fertilization.
Rights and permissions
About this article
Cite this article
Shahine, L.K., Burney, R.O., Behr, B. et al. Embryo quality before and after surgical treatment of endometriosis in infertile patients. J Assist Reprod Genet 26, 69–73 (2009). https://doi.org/10.1007/s10815-008-9287-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10815-008-9287-1