Surgical treatment of endometriosis does not affect outcomes of IVF/ICSI patients: a retrospective single-institution experience

Background: To compare outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles in patients with stage I-II endometriosis with and without previous surgical treatment. Methods: This is a retrospective cohort study of prospectively collected data from June 2006 to June 2016. Infertile women with stage I-II endometriosis and AMH ≥1 ng/mL, that had undergone IVF/ICSI in our center, were included. Patients were divided into two groups, group 1 consisting of women that had undergone surgical treatment of endometriosis and group 2, consisting of those without medical treatment only. Surgical excision could have been performed within the previous 24 months before the IVF/ICSI attempt. Only patients with endometriosis being the unique cause of infertility were included. Patients with endometriomas >3 cm were excluded from the present study. Primary outcomes were defined to be clinical pregnancy rate and live birth rate. Secondary outcomes were implantation rate, biochemical pregnancy rate, early miscarriage rate and twin pregnancy rate. Results: There were overall 512 patients with stage I-II endometriosis that finally underwent IVF/ICSI and were included in the present study. Of these, 291 patients had been operated for endometriosis (group 1), while the rest 221 patients were treated conservatively (group 2). Clinical pregnancy rate, live birth rate as well as b-hCG (+) rate, implantation rate and twin pregnancy rate were comparable between study groups. Specifically, clinical pregnancy rate was 48.6% (n=141) vs. 41.1% (n=91), (P=0.11), while live birth rate was 41.5% (n=121) vs. 34.3% (n=76), (P=0.13). Conclusions: The present study demonstrated that surgical treatment before IVF/ICSI in stage I-II endometriotic patients does not significantly affect the final reproductive outcome.