Women with combined adenomyosis and endometriosis on MRI have worse IVF/ICSI outcomes compared to adenomyosis and endometriosis alone: A matched retrospective cohort study.

Autor: Rees CO; Department of Gynaecology and Obstetrics, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, Netherlands; Department of Reproductive Medicine, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium. Electronic address: connie.rees@catharinaziekenhuis.nl., Rupert IAM; Department of Gynaecology and Obstetrics, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, Netherlands., Nederend J; Department of Radiology, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, Netherlands., Consten D; Department of Reproductive Medicine, Elizabeth-Twee Steden Hospital, Hilvarenbeekse Weg 60, 5022 GC Tilburg, Netherlands., Mischi M; Department of Electrical Engineering, Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, Netherlands., A A M van Vliet H; Department of Gynaecology and Obstetrics, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, Netherlands; Department of Reproductive Medicine, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium., Schoot BC; Department of Gynaecology and Obstetrics, Catharina Hospital, Michelangelolaan 2, 5623EJ Eindhoven, Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Groene Loper 19, 5612 AP Eindhoven, Netherlands; Department of Reproductive Medicine, University Hospital Ghent, C. Heymanslaan 10, 9000 Ghent, Belgium.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2022 Apr; Vol. 271, pp. 223-234. Date of Electronic Publication: 2022 Feb 24.
DOI: 10.1016/j.ejogrb.2022.02.026
Abstrakt: Study Objectives: To assess the effect of adenomyosis, endometriosis and combined adenomyosis and endometriosis, diagnosed on MRI, on IVF/ICSI outcomes versus male subfertility controls.
Study Design: This single-centre matched retrospective cohort study was carried out at Catharina Hospital in Eindhoven, The Netherlands. The study group consisted of infertile women undergoing their first, fresh embryo transfer during IVF/ICSI, with adenomyosis only (N = 36), endometriosis only (N = 61), and combined adenomyosis and endometriosis (N = 93) based on MRI. The control group consisted of IVF/ICSI patients undergoing treatment due to male subfertility (N = 889). 1:2 case-control matching based on age during IVF/ICSI, parity and number of embryos transferred was performed. Odds ratios were calculated for biochemical pregnancy, ongoing pregnancy and live birth rate versus matched male subfertility controls, and were corrected for embryo quality.
Results: Only the combined adenomyosis and endometriosis group showed a significantly reduced OR for biochemical pregnancy (p = 0.004, OR 0.453 (95% CI :(0.284-0.791)), ongoing pregnancy (p = 0.001, OR 0.302 (95% CI: (0.167-0.608)) and live birth (p = 0.001, OR 0.309 (95% CI: (0.168-0.644)) compared to matched male subfertility controls.
Conclusions: The lower (ongoing) pregnancy and live birth rates in the combined adenomyosis and endometriosis women can be attributed to more severe disease in these women, ultimately resulting in increased chances for failed implantation and miscarriage. This highlights the importance of screening for adenomyosis in endometriosis patients, and identifies these women target for additional (hormonal) treatment prior to IVF/ICSI.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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