Diagnosis of polycystic ovarian syndrome (PCOS) or endometriosis is associated with lower pregnancy rates in women undergoing in vitro fertilization and embryo transfer (IVF-ET)

Abstract

To determine outcome of IVF-ET in women with a diagnosis of PCOS or endometriosis compared to a control group of fertile women with tubal ligation who underwent IVF-ET. A case-control study. The study included 813 consecutive women who underwent IVF-ET treatment from 2002 & 2005 with the diagnosis of PCOS (NIH-consensus criteria) in 408 women and endometriosis (confirmed surgically) in 354 women. The rest of the women included a control group of 51 women who underwent IVF-ET because of bilateral tubal ligation. The control group included women with proven fertility (including their male partners). Primary outcome included clinical pregnancy rate while secondary outcomes included implantation rate, pregnancy loss rate & cycle characteristics. Statistical analysis was done comparing the control group (tubal ligation) with the each one of the other two study groups (endometriosis & PCOS groups). There was no statistically significant difference between the control and each of the study groups as regards age, type of stimulation protocol or number of retrieved mature oocytes. Clinical pregnancy rate was significantly lower in each of the study groups compared to the control group while the rate of pregnancy loss was significantly lower in the control group. Table 1Characteristics & treatment outcomes in women <35 yrs & ≥35 yrs<35 Yrs≥35 YrsEndometriosisPCOSTubal LigationEndometriosisPCOSTubal LigationIVF-ET Cycles∗2283071912610132Pregnancies∗124 (54%)158 (52%)12 (63%)62 (49%)46 (46%)16 (50%)Clinical Pregnancies∗100 (44%)136 (44%)12 (63%)46 (37%)36 (36%)14 (44%)Pregnancy loss∗24 (19%)22 (14%)0 (0%)16 (26%)10 (22%)2 (13%)Implantation rate24%28%31%16%19%23%Embryos transferred∗∗2.8 ± 12.7 ± 12.7 ± 13.2 ± 13 ± 12.9 ± 1Age∗∗31 ± 2.830 ± 3.231 ± 2.737 ± 2.237 ± 2.239 ± 2.8Data presented as: Number (rate)∗ and Mean ± SD∗∗. Open table in a new tab Data presented as: Number (rate)∗ and Mean ± SD∗∗. Compared to a cohort of control group that included women with proved fertility (tubal ligation), the diagnosis of endometriosis or PCOS was associated less favorable treatment outcomes (lower clinical pregnancy rates and higher rates of pregnancy loss).