Endometriosis surgery and IVF success: when is the right time to begin fertility treatment?

This study investigated whether endometriosis surgery impacted pregnancy rates as a result of in vitro fertilization (IVF).

They found that the severe endometriosis resulted in lower IVF pregnancy rates and the optimal time for IVF is 7-25 months following endometriosis surgery.

Endometriosis is a chronic condition where the endometrium, or uterine lining, forms outside of the uterus. This can cause pain and greatly impact quality of life and female fertility. Medication used to treat endometriosis also impairs fertility, so surgical intervention may be necessary. This is a minimally invasive or “laparoscopic” procedure, however there is a chance it may damage ovarian reserve (eggs in the ovary).

Some studies have suggested that endometriosis surgery can negatively impact the success of in vitro fertilization (IVF). It is unknown whether the time interval between surgery and IVF also affects IVF outcomes. 

This study addresses endometriosis surgical treatment and IVF outcomes in infertile women.

This study included data from 216 infertile women who underwent laparoscopic surgery and an IVF cycle and 209 control (IVF alone) patients. Data included information on the success rate of IVF, average time from surgery to IVF and other parameters.  

Fertilization and implantation rates were similar in patients who underwent surgery and those that did not. Pregnancy rates were significantly lower in patients who underwent surgery for severe (stage 3 and 4) endometriosis (35%) compared to control (45%). The presence of endmetriomas (cysts) did not affect pregnancy rates. Patients who underwent IVF 7-25 months following surgery had a higher pregnancy rate than other intervals.  

This study concluded that endometriosis severity negatively impacts IVF pregnancy rates in infertile women. 7-25 months is a favorable interval for IVF following surgery.

As this was a retrospective study, the most appropriate outcome measure (live birth rate) could not be used. The IVF treatment cycles can vary from patient to patient. 

If you have any concerns regarding fertility treatment, please discuss with your doctor.