Indirect markers of oocyte quality in patients with ovarian endometriosis undergoing IVF/ICSI: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of mixed study designs (observational cohort, case-control, and randomized trials).
PubMed 38943812 · doi:10.1016/j.rbmo.2024.104075
What was done
Authors conducted a systematic review and meta-analysis searching MEDLINE, the Cochrane Controlled Trials Register, and ClinicalTrials.gov through October 2023. They included randomized controlled trials, case-control studies, and cohort studies comparing indirect markers of oocyte quality during IVF/ICSI cycles between patients with ovarian endometriomas (OMA) and controls without anatomical or functional ovarian abnormalities.
What was found
Thirty-one studies were included. Compared to controls, patients with OMA showed no significant difference in: - Fertilization rate: OR 1.10 (95% CI 0.94 to 1.30) - Blastulation rate: OR 0.86 (95% CI 0.64 to 1.14) - Cancellation rate: OR 1.06 (95% CI 0.78 to 1.44) - Ovarian Sensitivity Index: mean difference -1.55 (95% CI -3.27 to 0.18) Patients with OMA had significantly lower numbers of: - Total oocytes retrieved: mean difference -1.59 (95% CI -2.25 to -0.94) - Mature (metaphase II) oocytes: mean difference -1.86 (95% CI -2.46 to -1.26) - Top-quality embryos: mean difference -0.49 (95% CI -0.92 to -0.06)
Why it matters
The findings indicate that while ovarian endometriomas compromise ovarian response and total oocyte yield, they do not appear to have an adverse impact on intrinsic oocyte developmental competence.
Limits
The meta-analysis included observational cohort and case-control studies alongside trials, which are prone to confounding. Direct markers of quality such as embryo euploidy rate could not be meta-analyzed due to insufficient published data. The total number of individual patients was not reported in the abstract.
Cited by
- contradicts Endometriosis reduces ovarian reserve (egg count) and egg quality.