The influence of endometriosis on the success of gamete intrafallopian transfer (GIFT).

Abstract

Our purpose was to evaluate the outcomes of gamete intrafallopian transfer (GIFT) therapy in patients with endometriosis. One hundred eight GIFT cycles performed under the indication of endometriosis were compared to 156 GIFT cycles with indications of other disease entities. A maximum of seven oocytes was transferred into one or both fimbriate ends with prepared spermatozoa. Clinical pregnancy rates and outcomes were evaluated according to Mantel-Haenszel's chi-square test. Multiple logistic regression analysis was performed to determine factors influencing the success on pregnancy in the total treatment cycles. The anthropological variables, such as age of patients, duration of infertility, and semen grading, were comparable in both groups. The responses to controlled ovarian hyperstimulation (COH) were progressively decreased while increasing the severity of endometriosis conditions such as nonendometriosis, mild-form endometriosis, and advanced-form endometriosis patients. However, there were no significant differences in the clinical pregnancy rates (40.4, 36.7, and 41.7%, respectively), multiple pregnancy rates (34.9, 27.3, and 45.0%, respectively), and early pregnancy loss rates (27.0, 18.2, and 30.0%, respectively). Multivariate statistics of pregnancy rates that adjusted the effects of patients' age, tubal health, presence of active endometriosis and/or endometriomas, number of oocytes transferred, and quality of sperm exhibited no statistical significance between endometriosis and nonendometriosis groups. Our data show that patients with records of endometriosis have both a decreased ovarian response to gonadotropin stimulation and a decreased number of retrieved oocytes. Since the number of oocytes needed for the GIFT procedure is limited, pregnancy results for patients in the study group were comparable with those for patients in the control group.