What is Endometriosis?

According to this study, endometriosis is “a benign estrogen-dependent, progesterone-resistant inflammatory disorder characterized by endometrial glands and stroma outside of the endometrial cavity, and associated with pain and infertility.” Endometriosis is when tissue that normally lines the uterus grows outside of the uterus and is very painful in most cases. It’s unclear whether endometriosis is associated with lower fertilization, implantation, pregnancy, and live birth rates in women undergoing IVF. Researchers take a closer look to determine how endometriosis may affect the process of IVF.

In this article we’ll look at:

• The researchers’ objectives and goals  
• Who were compared and how? 
• Whether or not endometriosis may be related to decreased implantation rates for infertile couples undergoing IVF

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‍Objective of the Study

What the researchers want to determine 

Based off of what we already know about endometriosis, the researchers want to determine whether surgically-confirmed endometriosis is associated with decreased implantation, pregnancy or live birth rates in women undergoing IVF. Albert L. Hsu, MD, Samantha R. Couture, MD. Alexander J. Titus and Judy E. Stern, PhD wrote the study out of Dartmouth-Hitchcock Medical Center.

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‍Methods & Variables 

Who were compared in the analysis?  

To find their results, researchers compared IVF cycles in women with surgically-confirmed endometriosis to IVF cycles in couples with male factor infertility. However, women with both factors were excluded from the analysis. Clinical pregnancies and live births per cycle were calculated as well as the calculation of implantation rate as heartbeats per embryos were transferred.

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Results & Wrap Up

What is there to be learned

There were 423 IVF cycles in women with surgically-confirmed endometriosis compared to 3,762 IVF cycles in couples with male factor infertility. The women with endometriosis were all considerably younger and in better shape. They also had a lower Anti-müllerian hormone (AMH). The level of AMH is typically a good indicator of a woman’s ovarian reserve. However, a statistically-significant decrease in implantation rates remained when adjusted for age, body mass index, AMH, as well as other infertility diagnoses. 

Overall, it’s concluded that surgically-confirmed endometriosis may be related to decreased implantation rates for infertile couples undergoing IVF. Though this decrease was not reflected in clinical pregnancy or live birth rates. As always, keep in mind that the information provided is meant to empower and inform you about the research done regarding fertility so you can have discussions with your doctor and advocate for yourself. Always consult your doctor prior to deciding on a treatment plan that is best for you!

Publication

"Endometriosis-associated infertility in the "EIVF" database"

Fertility and Sterility - September 2018, Volume 110, Issue 4, Supplement, Page e382

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