In vitro fertilization is a successful treatment in endometriosis-associated infertility

Objective To assess success rates of IVF and intracytoplasmic sperm injection in women with various stages of endometriosis. Design Retrospective cohort study. Setting Reproductive medicine unit in a university hospital. Patient(s) Infertile women (n = 2,245) with various stages of endometriosis or tubal factor infertility. Intervention(s) IVF or intracytoplasmic sperm injection. Main Outcome Measure(s) Dose of FSH, number of oocytes retrieved, fertilization rate, implantation rate, pregnancy rate (PR), live birth/ongoing PR. Result(s) Women with endometriosis had similar pregnancy and live birth/ongoing PR as did women with tubal factor infertility, but the American Society for Reproductive Medicine (ASRM) stage I and II endometriosis patients had a lower fertilization rate, and stage III and IV patients required more FSH and had fewer oocytes retrieved. Splitting the stage III and IV groups into patients with and without endometriomas showed that the endometrioma group required more FSH and had a significantly lower pregnancy and live birth/ongoing PR. Conclusion(s) With the exception of patients with endometrioma, infertile women with various stages of endometriosis have the same success rates with IVF and intracytoplasmic sperm injection as patients with tubal factor. This contrasts with the systematic review on which the European Society of Human Reproduction and Embryology bases its recommendations.