Outcome Of IVF-ET In Patients With Endometriosis In Comparison With Tubal-Factor Infertility

Objective:The aim of this retrospective study was to compare the outcome of in vitro fertilization and embryo transfer in women with endometriosis and a control group with tubal-factor infertility.Methods:A retrospective study was carried out in Reproductive Health Centre of 1st affiliated hospital of Guangxi medical university. Study was carried out in Thirty-eight patients of endometriosis who has undergone IVF for management of infertility consisted of 40 IVF-ET cycles from October 2007 to December 2010&compared with control group from the same duration of year & age. The matched control group with tubal-factor infertility consisted of 100 IVF-ET cycles in 100 patients. According to surgical grouping:peritoneal type 14 IVF-ET cycles, ovarian type 21 IVF-ET cycles, non-surgical 5 IVF-ET cycles; According to the falling tone scheme grouping:ultra-long scheme falling tone 15 IVF-ET cycles, corpus luteum middle long scheme falling tone 25 IVF-ET cycles; The normal group of CA125 26 IVF-ET cycles, elevated group 14 IVF-ET cycles. Between the two groups other factors, including patient age, infertility fixed number of year, basic FSH and LH, E2 value, basic AFC comparative difference was statistically significant, two groups of infertility patients exclude other system disease, the man semen conventional all normal or mild little weak sperm. Both groups to routine IVF-ET. These groups were retrospectively analyzed regarding stimulation, fertilization, embryo development, implantation, abortion, and pregnancy outcome.Results:Group compared with controls, Gn starting dose and Gn average daily dosage and Gn use total more than control group, the difference was statistically significant (p<0.05), the numbers of follicles≧14mm and E2 value of the day of HCG injection, won the egg number, number of embryos that were significantly less than the control group, the difference was statistically significant (p<0.05), Embryo development rate and the optimal embryo rate lower than that in control group, the difference was statistically significant (p<0.05), Pregnancy rate and planting rate all lower than those of the control group, the abortion rate is higher than control group, but the difference was not statistically significant. Fertilization rate and number of embryos of surgical groups more then the non-surgical groups, The Gn start dose and average daily dosage of ovarian type more then peritoneal type, The Gn start dose and average daily dosage and Gn use total of ultra-long scheme more than long scheme, Fertilization rate and embryo development rate of the normal group of CA125 more then elevated group, the difference was statistically significant (p<0.05).Conclusion: 1. Our results show that women with endometriosis reduce the ovary to COH response, reduce won the eggs number and portable embryo several, reduce embryo development rate and the optimal embryo rate, Planting rate has been declining trend, abortion rate is higher trend. compared with women with tubal-factor infertility. But this conclusion may be caused by Ems disease itself, can also be caused by falling tone caused the different scheme.2.Before IVF, Laparoscopic surgery may improve fertilization rate and increase the number of embryos, pregnancy rates and planting rate is can be higher trend. Laparoscopic surgery before IVF is not clear to help outcome of IVF.3. Ovarian type endometriosis compared to peritoneal type endometriosis might affect ovarian to COH reactions and the pregnancy outcome, the differences were also may be due to the different damage of ovarian surgery.4. Ultra-long scheme falling tone will reduce the ovary to COH response, but not necessarily improve IVF outcome. Pregnancy rate and planting trend is can be higher trend.5 Fertilization rate and embryo development rate of the normal group of CA125 is higher than abnormal group, the ending have slightly good trend.