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Posted by on Jul 14, 2019 in Infertility | 0 comments

In a nutshell

This study investigated live birth rates (LBR) in women surgically-treated for endometriosis (EDM).

They found that LBR was similar in women who were surgically-treated and those who did not have surgery. 

Some background

Endometriosis (EDM) is a leading cause of infertility. The endometrium is the tissue lining of the uterus. In EDM, tissue grows outside the uterus. They can form masses on the ovaries called endometriomas (EDMAs). Patients with EDM do not ovulate regularly. This can make it difficult to achieve a pregnancy naturally. 

Assisted reproduction techniques (ART) are used by patients with EDM. These include in vitro fertilization (IVF). Some doctors will perform surgery to remove EDMAs before starting IVF. EDMAs can have a number of negative effects on fertility. However, some studies suggest that surgical treatment (ST) may affect IVF success. IVF success Is measured by live birth rates (LBR). It is unclear if LBR is affected by ST in patients treated for EDM.

Methods & findings

This study analyzed data from 13 clinical trials. These studies included patients with EDM. Some patients underwent ST. Other patients did not have any surgery (non-ST). This type of approach is called expectant management. The authors compared fertility outcomes. The primary outcome was LBR. They also compared miscarriage rates (MR) and ovarian parameters such as the number and quality of oocytes (eggs). 

There was no significant difference in LBR between ST and non-ST patients. There was no difference in other fertility outcomes including MR. The number of oocytes retrieved was significantly lower in ST patients. 

The bottom line

The authors concluded that LBR was similar in ST and non-ST before IVF in patients with endometriosis.

The fine print

12 of the studies analyzed were observational trials. This means that patients were not randomly assigned to ST or non-ST. It can be more difficult to detect a difference in these types of trials. More investigation is needed.

What’s next?

If you have any concerns regarding infertility please consult with your doctor.

Published By :

Journal of Minimally Invasive Gynecology

Date :

Feb 01, 2019

Original Title :

Live Birth Rate after Surgical and Expectant Management of Endometriomas after In Vitro Fertilization: A Systematic Review, Meta-Analysis, and Critical Appraisal of Current Guidelines and Previous Meta-Analyses.

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