The impact of endometrioma on in vitro fertilisation/intra-cytoplasmic injection IVF/ICSI reproductive outcomes: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational studies.
PubMed 32979078 · doi:10.1007/s00404-020-05796-9
What was done
A systematic review and meta-analysis of studies indexed in PubMed, BIOSIS, and MEDLINE up to September 2019 assessed the impact of endometrioma on IVF/ICSI outcomes. The primary outcome was live birth rate (LBR). Secondary outcomes included clinical pregnancy rate (CPR), implantation rate (IR), total oocytes retrieved, metaphase II (MII) oocytes retrieved, total and top-quality embryos, and gonadotrophin stimulation dose and duration. Random-effects models were used when significant heterogeneity was present.
What was found
Based on 8 included studies, women with endometrioma had significantly lower numbers of total oocytes retrieved (weighted mean difference [WMD] -2.25; 95% CI -3.43 to -1.06; p = 0.0002) and MII oocytes retrieved (WMD -4.64; 95% CI -5.65 to -3.63; p < 0.00001) compared to controls. All other measured outcomes—gonadotrophin dose and duration, total embryos, high-quality embryos, CPR, IR, and LBR—were reported as similar between groups (no effect sizes or numbers for these secondary outcomes were provided in the abstract).
Why it matters
This synthesis suggests that while endometrioma reduces ovarian response in terms of oocyte yield, it may not impair clinical pregnancy or live birth success in IVF/ICSI cycles.
Limits
The review includes only 8 studies, and the abstract does not report the total participant sample size. Primary and secondary clinical efficacy endpoints (LBR, CPR, IR) are reported only as similar without point estimates, confidence intervals, or heterogeneity statistics. Confounding by prior surgical history or endometrioma size was not detailed in the abstract.
Cited by
- partial Endometriosis reduces ovarian reserve (egg count) and egg quality.