Do ovarian endometriomas affect ovarian response to ovarian stimulation for IVF/ICSI?

Autor: Clara Pardos, Ignacio Rodríguez, Iñaki González-Foruria, S Garcia, Pedro N. Barri, Jorge Rodriguez-Purata, Pedro N Barri Soldevila, Nikolaos P. Polyzos, M. Angela Pascual
Rok vydání: 2020
Předmět:
Adult
0301 basic medicine
Infertility
endocrine system
medicine.medical_specialty
Pregnancy Rate
endocrine system diseases
medicine.medical_treatment
Endometriosis
Oocyte Retrieval
Fertilization in Vitro
Intracytoplasmic sperm injection
03 medical and health sciences
0302 clinical medicine
Ovarian Follicle
Ovulation Induction
Pregnancy
Humans
Medicine
Ovarian Diseases
Sperm Injections
Intracytoplasmic
Ovarian Reserve
Ovarian reserve
Retrospective Studies
Gynecology
030219 obstetrics & reproductive medicine
biology
business.industry
Ovary
Age Factors
Obstetrics and Gynecology
Anti-Müllerian hormone
Nomogram
Antral follicle
medicine.disease
female genital diseases and pregnancy complications
Confidence interval
Nomograms
Cross-Sectional Studies
Treatment Outcome
030104 developmental biology
Reproductive Medicine
biology.protein
Female
business
Developmental Biology
Zdroj: Reproductive BioMedicine Online. 41:37-43
ISSN: 1472-6483
DOI: 10.1016/j.rbmo.2020.03.013
Popis: Research question Does the presence of ovarian endometriomas affect ovarian response to ovarian stimulation after adjusting for age and ovarian reserve markers? Design This retrospective cross-sectional study compared the ovarian response between patients with ovarian endometriomas and women with other infertility factors undergoing their first ovarian stimulation for IVF/intracytoplasmic sperm injection (ICSI). An age-specific nomogram model for the number of oocytes retrieved was built for both groups, and ovarian response was compared after adjusting for age, gonadotrophin dose, anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC). Results A total of 923 patients were included: 101 women with at least one ovarian endometrioma, and 822 patients with other infertility factors. Comparisons of the nomograms for the number of oocytes retrieved demonstrated that response was significantly lower for women with endometrioma when the results were adjusted for age the z-score for the number of oocytes retrieved (–0.49 ± 0.71 versus –0.20 ± 0.86; 95% confidence interval [CI] –0.47 to –0.12) and also after adjustment for the total dose of gonadotrophins and AMH values (z-score mean difference –0.338; 95% CI –0.54, –0.14). When the z-score was adjusted for gonadotrophin dose and AFC, the number of oocytes retrieved was comparable between the two groups (z-score mean difference –0.038; 95% CI –0.34 to 0.27). Conclusions Ovarian response after ovarian stimulation for IVF/ICSI in women with endometriomas is significantly lower than in controls after adjusting for age, gonadotrophin dose and AMH. Dose and protocol selection for ovarian stimulation in patients with endometrioma should be based on AFC rather than AMH, as the latter may be overestimated.
Databáze: OpenAIRE
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