Document Detail


Deep pelvic endometriosis negatively affects ovarian reserve and the number of oocytes retrieved for in-vitro fertilization.
MedLine Citation:
PMID:  21542809     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. Endometriosis-associated infertility results in reduced ovarian response, fewer oocytes available for fertilization, compromised oocyte quality and higher miscarriage rates. A consistent proportion of women with endometriosis require IVF. We sought to clarify the impact of deep infiltrating pelvic disease on antral follicle count and ovarian response to FSH stimulation in patients with severe endometriosis. Design. Retrospective cohort study. Setting. University Hospital. Population. Patients with severe endometriosis (stages III-IV) (n = 51) were divided into two groups regarding localization of endometriosis during surgical staging: ovarian (n = 27) and both ovarian and deep infiltrating disease (n = 24). Methods. A total of 73 long protocol ovulation induction cycles with r-FSH for an ICSI program were given. On Day 3 of the cycle, measurements of FSH, LH and an ultrasound evaluation of antral follicle count were performed. Main Outcome Measures. Number of oocytes collected at ovum pick-up, number of mature oocytes, number of embryo-transferred, and clinical pregnancy rate. Results. Ovarian reserve in terms of antral follicle count was damaged in both groups but, if adjusted for age, it was significantly lower in the ovarian and pelvic infiltrating group compared to patients with only ovarian endometriosis. Pelvic deep infiltrating disease significantly impacted on the number of oocytes collected at pick up when adjusted for age. Conclusions. Deep infiltrating pelvic disease can negatively affect ovarian reserve in terms of antral follicle count and number of oocytes retrieved. Mechanisms underlying this phenomenon need to be elucidated.
Authors:
Enrico Papaleo; Jessica Ottolina; Paola Vigano'; Claudio Brigante; Elena Marsiglio; Francesca DE Michele; Massimo Candiani
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-4
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors AOGS© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Infertility Unit, Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy.
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