Presence of Endometrioma Decreased Blastocyst Formation Rate but Not Impair Assisted Reproductive Technology (ART) outcome

Abstract Purpose: These study aims to assess the impact of endometrioma on patients who undergo ART treatment due to endometriosis. Methods: Retrospective study was conducted in women ≤ 40 years of age who underwent ART treatment at an academic medical center between January 2014 and December 2020. Two-hundred-and-eight women had received IVF/ICSI treatment due to endometriosis and there were 89 patients’ presence of endometrioma. Patients were further divided into primary endometrioma, recurrent endometrioma and those having received cystectomy for endometrioma prior to IVF/ICSI. The control group included 624 infertile women without endometriosis. Results: In the endometrioma subgroup (B) the blastocyst formation rate was significantly lower when compared with the endometriosis (A) and control groups (C). The cumulative live birth rates (CLBRs) (60.5% versus 49.4% versus 56.9%, p=0.194 in A versus B, p=0.406 in A versus C, p=0.878 in B versus C) were comparable. Multiple logistic regression analysis revealed that female age, total FSH dose and blastocyst formation rate were the significant variables in predicting CLBR (OR: 0.89, CI: 0.80–0.99, p < 0.025, OR:0.68 CI:0.53-0.88, p=0.003 and OR: 30.04, CI: 9.93–90.9, p < 0.001, respectively). The CLBRs were comparable 47.1%, 60% and 57.9% in the primary endometrioma, s/p cystectomy and recurrent endometrioma group. Conclusion: Although the blastocyst formation rate was lower in the endometrioma group, CLBR was not worse than those who were in the endometriosis or control group. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if ovarian reserve was comparable. Recurrent endometrioma did not worsen IVF/ICSI outcomes than primary endometrioma.