Elena-Silvia Nadă

Endometriosis is a benign chronic disease with a major impact on a woman’s quality of life, mainly due to painful physical symptoms. Endometriosis

Endometriosis is a common cause of infertility among reproductive-age women. A low ovarian reserve is associated with the presence of endometriotic cysts, and this is accentuated even more after surgery. Patients with a history of endometrioma are a special category of poor ovarian reserve requiring in vitro fertilization (IVF). The aim of this retrospective study was to evaluate the characteristics and outcome of ovarian stimulation and embryo transfer in women with a history of ovarian surgery for endometrioma compared with a control group with tubal factor infertility. A total of 146 patients had previous laparoscopic cystectomy for endometrioma (group A) and their IVF results were compared with 136 patients with documented tubal obstruction (group B). In both groups, the most frequently used ovarian stimulation protocol was the short antagonist in 84.24% versus 80.88%. The number of stimulation days was between 6 and 15 days in the two groups with a mean value of 12.76 days in group A and 9.47 days in group B. The clinical pregnancy rate was 26.77% in the endometrioma group and 39.68% in the tubal obstruction group. Patients with a history of endometrioma are less likely to conceive than those with tubal obstruction despite having similar ovarian reserve and stimulation results.

Introduction:Endometriosis is a common inflammatory disease and a major cause of infertility through various mechanisms. Materials and method: We conducted a retrospective study in infertile women with endometriosis who underwent in vitro fertilization (IVF) in order to evaluate the particularities and outcome of ovarian stimulation. Results:A total of 59 patients aged 24-40 years were included. Clinical characteristics of the studied group revealed dysmenorrhea in 66.66% of cases, previous ovarian surgery in 57.89% and primary infertility in 78.94%. The most used protocol was the short one with antagonist (64.91%), followed by the long protocol with agonist (22.80%), and Dual-stim protocol (12.28%). The number of ovarian stimulation days varied between 8-14 days. The total number of oocytes obtained ranged between 0-12. Standard IVF was performed in 40.35% of cases and FIV-ICSI in 59.64% of cases; 78.94% of patients were able to obtain an embryo and blastocysts were obtained in 42.10% of cases. All patients aged under 35 obtained at least one viable embryo. Fresh or frozen single embryo transfer was furtherly performed with a day 3 embryo or a blastocyst. Fresh embryo transfer was mainly performed with day 3 embryos (60.46%). The overall biochemical pregnancy rate in the studied lot was 35.59%. The biochemical pregnancy rate was 40% in the group of patients aged under 35 and 35.13% in the group aged over 35 years. Conclusion:Women with endometriosis are a special category of poor ovarian response mainly due to the decline in ovarian reserve and inferior IVF results are expected due to a lower number of retrieved oocytes, lower fertilization rates, poor embryo quality and altered endometrial receptivity.