Influencing factor analysis of pregnancy outcomes in in vitro fertilization-embryo transfer in patients with pelvic endometriosis associated infertility after laparoscopy treatment

Abstract

Objective To analyze the multiple factors related to in vitro fertilization-embryo transfer (IVF-ET) pregnancy outcomes in infertile patients with pelvic endometriosis (EMS) after the laparoscopic surgery. Methods We collected 265 cases of EMS with infertility that received the first IVF-ET treatment after laparoscopic in Henan Reproductive Hospital from Jan. 2015 to Oct. 2017. Univariate analysis and multivariate logistic regression analysis were used to analyze the factors related to IVF cumulative pregnancy rate after surgery. Results 1) Totally 165 cases were pregnant and the overall cumulative clinical pregnancy rate was 61.51%. Univariate analysis showed that antral follicle count (AFC), revised American Fertility Society (r-AFS) stage, endometriosis fertility index (EFI) score, age of the surgery, excision of ovary EMS in operation, time interval between surgery and IVF, controlled ovulation stimulation(COS) protocol, oocytes retrieved, available embryos were related to IVF cumulative pregnancy rate (P 3 years (OR=0.513, P=0.041) were the risk factors of postoperative IVF cumulative pregnancy rate. Downregulation protocol (OR=6.489, P=0.001), and more available embryos (OR=1.729, P=0.001) were the protective factors of postoperative IVF cumulative pregnancy rate. 3) The rate of IVF cumulative pregnancy rate was decreased gradually with the postoperative time (P=0.041). Conclusion The advanced age, high level r-AFS stage, low EFI score, long time interval, non-downregulation protocol, less available embryos are important risk factors affecting postoperative IVF pregnancy outcomes in those patients with EMS after laparoscopic treatment. Comprehensive assessment and shortening the waiting time after laparoscopic surgery can achieve a more ideal IVF-ET pregnancy outcome. Key words: Endometriosis; Laparoscopy; Reproductive techniques, assisted; Pregnancy outcome; Infertility