The document discusses several studies related to endometriosis and IVF outcomes. It provides summaries of studies that examined: - Live birth rates, clinical pregnancy rates, number of oocytes retrieved, and miscarriage rates for patients with endometriosis undergoing IVF compared to controls. - IVF outcomes based on the severity of endometriosis compared to controls. - Outcomes of fresh versus frozen embryo transfers. - The risk of embryonic aneuploidy in patients with endometriosis. - Treatment guidelines from ESHRE on the use of IVF and surgery for infertility associated with endometriosis.

1. Endometriosis – IVF
Dr TEVFİK YOLDEMİR BSc. MA. PhD.
yoldemirtevfik

2. Age pattern in 42,079 patients with endometriosis
Arch Gynecol Obstet (2012) 286:667–670

3. Incidence of endometriosis in a UK-based population analysis
THE EUROPEAN JOURNAL OF CONTRACEPTION & REPRODUCTIVE HEALTH CARE, 2017
https://doi.org/10.1080/13625187.2017.1374362

4. Best Practice & Research Clinical Obstetrics and Gynaecology 51 (2018) 25-33

5. Best Practice & Research Clinical Obstetrics and Gynaecology 51 (2018) 25-33

6. (Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

7. (Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

8. Overall live birth rate
endometriosis versus control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

9. Overall clinical pregnancy rate
endometriosis versus control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

10. Overall mean number of oocytes retrieved from
endometriosis versus control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

11. Overall miscarriage rates
endometriosis versus control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

12. Live birth rate
endometriosis severity vs control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

13. Clinical pregnancy rate
endometriosis severity versus control
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

14. Mean number of oocytes retrieved
disease severity versus control.
(Obstet Gynecol 2015;125:79–88)
DOI: 10.1097/AOG.0000000000000592
Overall

15. IVF Outcomes
Endo vs Control
Ultrasound Obstet Gynecol 2014; 44: 261–278
Overall

16. Endometrioma & IVF/ICSI outcomes
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

17. antral follicle count and the total number of
follicles at the time of hCG administration
Fertil Steril2015;103:1544–50.
Data are presented separately for
(A) nonoperated gonads without
endometriomas (n = 42),
(B) nonoperated gonads with
endometriomas (n = 46),
(C) previously operated gonads without
endometriomas (n = 55), and
(D) previously operated gonads with
endometriomas (n = 23).
OMA

18. AMH levels
the type of endometriosis and prior OMA surgery
Human Reproduction, Vol.27, No.11 pp. 3294–3303, 2012
AMH levels according to prior endometriosis surgery or
the absence of prior endometrioma surgery (P < 0.01).
OMA

19. AMH levels
OMA and past OMA surgery.
Human Reproduction, Vol.27, No.11 pp. 3294–3303, 2012
OMA

20. LBR, CPR, MR and CR
endometrioma versus no endometrioma
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

21. MNOR, Baseline FSH, Total FSH, AFC
endometrioma versus no endometrioma.
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

22. LBR, CPR,MR and CR
endometrioma versus peritoneal endometriosis
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

23. MNOR, Baseline FSH and AFC
endometrioma versus peritoneal endometriosis.
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

24. LBR, CPR,MR and CR
treated endometrioma versus intact endometrioma
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

25. MNOR, Baseline FSH, Total FSH and AFC
treated endometrioma versus intact endometrioma.
Human Reproduction Update, Vol.21, No.6 pp. 809–825, 2015
OMA

26. endometrioma - live birth
Surgery versus Conservative
Acta Obstet Gynecol Scand 2017; 96:727–735.
OMA

27. endometrioma - live birth
Surgery versus conservative
Acta Obstet Gynecol Scand 2017; 96:727–735.
OMA

28. endometrioma - clinical pregnancy
Surgery versus conservative
Acta Obstet Gynecol Scand 2017; 96:727–735.
OMA

29. endometrioma - antral follicle count
Surgery versus conservative
Acta Obstet Gynecol Scand 2017; 96:727–735.
OMA

30. endometrioma
Acta Obstet Gynecol Scand 2017; 96:727–735.
OMA

31. Am J Obstet Gynecol 2017;216:280.e1-9.
http://dx.doi.org/10.1016/j.ajog.2016.11.1042
OMA

32. ovarian endometriotic cystectomy
unilateral versus bilateral
Human Reproduction Update, pp. 1–17,
2019 doi:10.1093/humupd/dmy049
OMA

33. AMH percentage reduction from baseline
unilateral and bilateral endometrioma cystectomy
Human Reproduction Update, pp. 1–17,
2019 doi:10.1093/humupd/dmy049
OMA

34. pre-operative AMH levels
unilateral versus bilateral endometrioma
Human Reproduction Update, pp. 1–17,
2019 doi:10.1093/humupd/dmy049
OMA

35. post-operative AMH levels
unilateral versus bilateral endometrioma
Human Reproduction Update, 1–17,
2019 doi:10.1093/humupd/dmy049
OMA
(A) 1 week to 1 month,
(B) 6 weeks to 6 months

36. post-operative AMH levels
unilateral versus bilateral endometrioma
9–12 months, following surgery.
Human Reproduction Update, pp. 1–17,
2019 doi:10.1093/humupd/dmy049
OMA

37. European Journal of Obstetrics & Gynecology and Reproductive Biology 172 (2014) 80–84
OMA

38. ovarian responsiveness during IVF
affected and contralateral intact gonads
Placenta 32 (2011) S238-S242
OMA

39. Excision of Ovarian Endometrioma
J Clin Endocrinol Metab, September 2012, 97(9):3146–3154
OMA

40. Excision of Ovarian Endometrioma
J Clin Endocrinol Metab, September 2012, 97(9):3146–3154
OMA

41. Clinical pregnancy and adenomyosis
Acta Obstetricia et Gynecologica Scandinavica 96 (2017) 715–726
ADE

42. Birth rate and adenomyosis
Acta Obstetricia et Gynecologica Scandinavica 96 (2017) 715–726
ADE

43. Miscarriage and adenomyosis
Acta Obstetricia et Gynecologica Scandinavica 96 (2017) 715–726
ADE

44. adenomyosis / AMH serum level
Clinical Pregnancy Rate - colorectal endometriosis
Human Reproduction, Vol.27, No.4 pp. 1043–1049, 2012
ADE
DIE

45. Fertil Steril 2010;94:2441–3.
DIE

46. Journal of Minimally Invasive Gynecology (2009) 16, 174–180
DIE

47. Age
CPR –colorectal endometriosis
Human Reproduction, Vol.27, No.4 pp. 1043–1049, 2012
DIE

48. Fertil Steril 2012;97:367–72.
OMA
DIE

49. OMA - DIE
Fertil Steril 2012;97:367–72.
OMA
DIE

50. Phenotypes
Am J Obstet Gynecol 2017;216:280.e1-9.
http://dx.doi.org/10.1016/j.ajog.2016.11.1042
SUP
OMA
DIE

51. Am J Obstet Gynecol 2017;216:280.e1-9.
http://dx.doi.org/10.1016/j.ajog.2016.11.1042
SUP
OMA
DIE

52. Am J Obstet Gynecol 2017;216:280.e1-9.
http://dx.doi.org/10.1016/j.ajog.2016.11.1042
SUP
OMA
DIE

53. Am J Obstet Gynecol 2017;216:280.e1-9.
http://dx.doi.org/10.1016/j.ajog.2016.11.1042
SUP
OMA
DIE

54. GnRH-agonist versus GnRH-antagonist
J Gynecol Obstet Hum Reprod (2017),
http://dx.doi.org/ 10.1016/j.jogoh.2017.09.007
Anta
Ago

55. ART-outcomes
fresh versus Def-ET
PLoS ONE 13(4): e0194800. https://doi.org/10.1371/journal.pone.0194800
FreshET
CryoET

56. ART-outcomes
fresh versus Def-ET
In the fresh ET group, all of the women began progesterone treatment (200 mg vaginal capsule t.i.d, Utrogestan,
Besins International, Montrouge, France) the day of the oocyte retrieval, and estradiol (E2) was delivered
transdermally (0.2 mg/day, through two Vivelledot 100 systems simultaneously, Novartis Pharma SA, Rueil
malmaison, France) or orally (8 mg/day, Provames, Sanofi Aventis, Paris, France) 48h after the ET.
In the Def-ET group, women received an estradiol (E2) priming regimen that was delivered transdermally (0.2
mg/day) or orally (8 mg/day). When endometrium thickness 7mm and progesterone < 1.5 ng/ml), vaginal
progesterone treatment was initiated at a dose of 200 mg t.i.d.
PLoS ONE 13(4): e0194800. https://doi.org/10.1371/journal.pone.0194800
FreshET
CryoET

57. risk of embryonic aneuploidy
Fertility and Sterility 2017 http://dx.doi.org/10.1016/j.fertnstert.2017.05.038
In the endometriosis group 1,880 blastocysts from 305 patients were analyzed,
and 23,054 blastocysts from 3,798 patients were included in the control group.
Aneup

58. risk of embryonic aneuploidy
Fertility and Sterility 2017 http://dx.doi.org/10.1016/j.fertnstert.2017.05.038
Aneup

59. ESHRE guideline
• In infertile women with AFS/ASRM Stage I/II endometriosis,
clinicians may perform IUI with controlled ovarian stimulation;
instead of expectant management, as it increases live birth rates
(Tummon et al., 1997); instead of IUI alone, as it increases
pregnancy rates (Nulsen et al., 1993).
• In infertile women with AFS/ASRM Stage I/II endometriosis,
clinicians may consider performing IUI with controlled ovarian
stimulation within 6 months after surgical treatment, since
pregnancy rates are similar to those achieved in unexplained
infertility (Werbrouck et al., 2006).
Human Reproduction, Vol.0, No.0 pp. 1 –13, 2014
doi:10.1093/humrep/det457

60. ESHRE guideline
• The GDG recommends the use of ART for infertility associated with
endometriosis, especially if tubal function is compromised or if
there is male factor infertility, and/or other treatments have failed.
• In infertile women with endometriosis, clinicians may offer
treatment with ART after surgery, since cumulative endometriosis
recurrence rates are not increased after controlled ovarian
stimulation for IVF/ICSI (D’Hoogheet al., 2006; Benaglia et al.,
2010;Coccia et al., 2010; Benaglia et al., 2011).
Human Reproduction, Vol.0, No.0 pp. 1 –13, 2014
doi:10.1093/humrep/det457

61. ESHRE guideline
• In women with endometriomas, clinicians may use antibiotic prophylaxis
at the time of oocyte retrieval, although the risk of ovarian abscess
following follicle aspiration is low (Benaglia et al., 2008).
• Clinicians can prescribe GnRH agonists for a period of 3–6 months prior to
treatment with ART to improve clinical pregnancy rates in infertile women
with endometriosis (Sallam et al., 2006).
• In infertile women with endometrioma larger than 3 cm there is no
evidence that cystectomy prior to treatment with ART improves pregnancy
rates (Donnez et al., 2001; Hart et al., 2008; Benschop et al., 2010).
Human Reproduction, Vol.0, No.0 pp. 1 –13, 2014
doi:10.1093/humrep/det457

62. ESHRE guideline
• In women with endometrioma larger than 3 cm, the GDG recommends
clinicians only to consider cystectomy prior to ART to improve
endometriosis-associated pain or the accessibility of follicles.
• The GDG recommends that clinicians counsel women with endometrioma
regarding the risks of reduced ovarian function after surgery and the
possible loss of the ovary. The decision to proceed with surgery should be
considered carefully if the woman has had previous ovarian surgery.
• The effectiveness of surgical excision of deep nodular lesions before
treatment with ART in women with endometriosis-associated infertility is
not well established with regard to reproductive outcome (Bianchi et al.,
2009; Papaleo et al., 2011).
Human Reproduction, Vol.0, No.0 pp. 1 –13, 2014
doi:10.1093/humrep/det457

63. Nomogram to predict clinical pregnancy
ICSI–IVF & endometriosis
Human Reproduction, Vol.27, No.2 pp. 451–456, 2012
The equation describing the probability of clinical
pregnancy was:
P = 1/(1 + exp (2X)) where
X = 4.89939–0.09937 × V1–1.33906 × V2 + 1.05553 ×
V3–0.57434 × V4,
V1 the patient’s age,
V2 the presence of DIE,
V3 AMH serum level (0 if ≤1 ng/ml and 1 if >1 ng/ml)
V4 the number of ICS–IVF cycles.

64. Assumptions used for the evaluations on the potential
relevance of egg banking in women with endometriosis
Human Reproduction, Vol.0, No.0 pp. 1–7, 2015
doi:10.1093/humrep/dev078

65. Validity of fertility preservation in different
clinical scenarios
Human Reproduction, Vol.0, No.0 pp. 1–7, 2015
doi:10.1093/humrep/dev078

66. The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

67. Slideshare.net/dryoldemir
yoldemirtevfik

68. Live birth rate per cycle
Surgery- Expectant
The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

69. Total number of oocytes
Surgery- Expectant
The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

70. Antral follicle count
Surgery- Expectant
The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

71. Number of mature oocytes
Surgery- Expectant
The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

72. Clinical pregnancy per cycle
Surgery- Expectant
The Journal of Minimally Invasive Gynecology (2018)
https://doi.org/10.1016/j.jmig.2018.08.029

73. LS ---> IVF
Archives of Gynecology and Obstetrics
https://doi.org/10.1007/s00404-017-4633-0

74. LS ---> IVF
Archives of Gynecology and Obstetrics
https://doi.org/10.1007/s00404-017-4633-0

75. The impact of IVF
deep invasive endometriosis
European Journal of Obstetrics & Gynecology and Reproductive Biology 2019
http://dx.doi.org/10.1016/j.eurox.2019.100073
DIE

76. Cumulative Pregnancy Rates
women without negative fertility factors
Fertility and Sterility 2017
http://dx.doi.org/10.1016/j.fertnstert.2017.07.002
ADE

77. Cumulative Live Birth Rates
women without negative fertility factors
Fertility and Sterility 2017
http://dx.doi.org/10.1016/j.fertnstert.2017.07.002
ADE

78. colorectal endometriosis-associated infertility
Live Birth Rates according to fertility factors.
Fertility and Sterility 2017
http://dx.doi.org/10.1016/j.fertnstert.2017.07.002
DIE

79. Cumulative Pregnancy Rates
women without negative fertility factors
Fertility and Sterility 2017
http://dx.doi.org/10.1016/j.fertnstert.2017.07.002
DIE

80. CLBRs
women without negative fertility factors
Fertility and Sterility 2017
http://dx.doi.org/10.1016/j.fertnstert.2017.07.002
DIE

81. cytoreductive surgery for adenomyosis
Acta Obstetricia et Gynecologica Scandinavica 96 (2017) 715–726
ADE