What is the impact of endometrioma on IVF/ICSI outcomes in patients with endometriosis: A retrospective study

Abstract Background Does endometrioma per se, different from endometriosis, have specific impacts on IVF/ICSI outcomes? Dose cystectomy of the endometrioma improve IVF/ICSI outcomes? Methods We retrospectively analyzed 2153 IVF/ICSI cases treated during Jan/01/2014 to Dec/31/2020 in VGHTC. Two-hundred-and-eight women receiving IVF/ICSI treatment due to endometriosis. The control group consisted of 624 infertile women without endometriosis. First, we divided 208 patients into those with endometrioma (89) and those only with endometriosis (119). Second, we divided patients into primary endometrioma, recurrent endometrioma and those having received cystectomy for endometrioma before IVF/ICSI. Reproductive outcomes were compared. Results We found in the endometrioma subgroup (B), the usage gonadotropin dose was significantly higher, and the blastocyst formation rate was significantly lower compared with endometriosis (A) and control group (C). The CLBR (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. From the second analysis, the blastocyst formation rate was significantly higher in the s/p cystectomy group. The CLBR were comparable (47.1%, 60% and 57.9% p = 0.194 in D versus E, p = 0.406 in D versus F, p = 0.878 in E versus F, in primary endometrioma (D), s/p cystectomy (E) and recurrent endometrioma group (F)). Conclusions Although the blastocyst formation rate was lower, and the usage gonadotropin dose was higher in the endometrioma group, CLBR was not worse than those with endometriosis or control. Cystectomy for endometrioma did not alter IVF/ICSI outcomes if ovarian reserve is comparable. Recurrent endometrioma did not worsen ART outcome than primary endometrioma.