Reproductive Outcomes of Segmented In Vitro Fertilization in Patients Diagnosed with Endometriomas

Abstract

Study ObjectiveTo assess the impact of ovarian endometriomas on endometrial receptivity in frozen embryo transfer (FET) of segmented in vitro fertilization (IVF) cycles. DesignRetrospective, matched-control study (Canadian Task Force classification II-2). SettingA single, private assisted-reproduction technology center. PatientsThirty patients diagnosed with unilateral or bilateral endometriomas were compared with 60 patients without endometriomas in a population of 1894 patients who underwent segmented IVF treatment between September 2014 and September 2016. InterventionIntracytoplasmic sperm injection with blastocyst freeze-all and FET. Measurements and Main ResultsThe primary endpoint of the study was a viable pregnancy (>14 weeks). The mean diameter of diagnosed endometriomas was 25.7 ± 10.6 mm. The median antral follicle count was significantly lower in the endometrioma group compared with the entire study population (11.5; interquartile range [IQR], 6.0–17.0 vs 14.0; IQR, 9.0–22.0; p = .042). The median number of mature ovarian follicles (≥14 mm) per antral follicle that developed during controlled ovarian stimulation was not significantly different between the groups (11.0 [IQR, 5.8–14.3] vs 10.0 [IQR, 6.0–15.8]; p = .908); however, the median number of oocytes retrieved was lower in the endometrioma group (11.5 [IQR, 6.0–21.5] vs 13.5 [IQR, 9.0–20.8]; p = .373). The biochemical pregnancy, implantation, and ongoing pregnancy rates were not significantly different between the endometrioma and control groups. ConclusionAlthough ovarian endometriomas result in reduced ovarian reserve and oocyte retrieval, their impact on reproductive outcome is limited with FET.