Effectiveness of IVF for Unexplained Infertility and Minimal to Mild Endometriosis-associated Infertility

Abstract

Objective: to evaluate the relative effectiveness of in vitro fertilization (IVF) for unexplained infertility and minimal to mild endometriosis-associated infertility with patent fallopian tubes and compare it to its effectiveness in infertile patients with a complete bilateral fallopian tube occlusion, as questioned by the Canadian Royal Commission on New Reproductive Technologies.Methods: patients were consecutively enrolled between 1992 and 2000 at PROCREA, a private tertiary human reproduction centre. Three groups of infertile patients treated with in vitro fertilization were historically compared: 192 IVF cycles performed for unexplained infertility, 112 IVF cycles for minimal to mild endometriosis-associated infertility with patent normal fallopian tubes, and 285 IVF cycles for bilateral fallopian tube occlusion. The main outcomes measured were rates of fertilization, implantation, and clinical pregnancy.Results: a significant difference between fertilization rates was found across groups (p < 0.0005). Clinical pregnancy rates per started cycle (defined as a pregnancy with a positive fetal heart) were 29.6 percent, 30.4 percent, and 28.1 percent for the first, second, and third group respectively.Conclusion:in vitro fertilization is as effective for treating unexplained infertility and minimal to mild endometriosis-associated infertility as it is for treating infertility caused by a complete bilateral fallopian tube occlusion.