Outcome of in vitro fertilization in endometriosis-associated infertility: a 5-year database cohort study.

Results The endometriosis group (n=177) had a markedly lower oocytes retrieved number, fertilization rate, implantation rate, and clinical pregnancy rate (7.6±5.1, 63.6%, 27.7%, and 45.2%, respectively) compared with the non-endometriosis group (n=4267; 11.8±7.3, 68.4%, 36.2%, and 55.2%, respectively). Stratified analysis showed that this difference was found in the subgroup younger than 35-years old, while only fertilization rate and implantation rate were different in the elder subgroup. The ratio of high-quality embryos transferred is lower in endometriosis group (53.7% vs. 71.8%, P <0.05), but there is no difference in IE/HQE ratio between two groups. There is no significant difference in fertilization rate, implantation rate, and clinical pregnancy rate between mild and severe endometriosis patients. Conclusions Endometriosis patients suffer a decreasing IVF pregnancy rates mainly caused by reducing oocytes number and fertilization rate, regardless of the severity of the disease. Appropriate intracytoplasmic sperm injection manipulation might improve the outcomes of IVF. Chin Med J 2012;125(15):2688-2693 ndometriosis is defined as the presence of endometrial-like tissue outside the uterus, most commonly on the ovary and peritoneum, and the main clinical features are chronic pelvic pain, dyspareunia, and infertility. Their common histologic features are the presence of endometrial stromal or epithelial cells, chronic bleeding, and signs of inflammation. The inflammation involved in endometriosis can stimulate nerve endings in the pelvis and thereby cause pain, impair the function of uterine tubes, decrease receptivity of the endometrium, and hinder development of the oocyte and embryo. Endometriosis can also cause infertility by physically blocking the fallopian tubes. 1 It was reported that women with endometriosis may have endocrine and ovulatory disorders, including luteinized unruptured follicle syndrome, impaired folliculogenesis, luteal phase defect, and premature or multiple luteinizing hormone