Though the endometriosis is not always related with infertility, endometriosis causes infertility in some patients. There are many treatment modalities of infertile patients who have endometriosis. In recent years, Assisted Reproductive
Technology
(ART)
have been widely accepted as being a useful tool for the treatment of infertile endometriotic patients.
The objective of this study was to evaluate the outcome of ART in infertile endometriotic patients who have been carried out IVF-ET from Jan, 1992 to Dec, 1994 and to compare the results between COH/IUI and IVF-ET I the patients with
endometriosis
stage
Ⅰ.
Tubal disease only patients were grouped (308 patient, 956 cycles) as a control. Endometriosis group was subdivided into 4 groups according to American Fertility Society classification; endometriosis stage Ⅰ (45 patients, 61 cycles), stage Ⅱ
(26
patients, 39 cycles), stage Ⅲ (26 patients, 37 cycles), stage Ⅳ (33 patients, 50 cycles).
@ES The outcomes of IVF-ET in endometriosis patients were as follows; @EN The oocyte recovery rates were significantly lower in stage Ⅲ, Ⅳ endometriosis. In case of stage Ⅲ endometriosis, the fertilization rate was significantly lower than
other
stages of endometriosis. Clinical pregnancy rates per cycle were not different between the tubal group (22%) and the endometriosis group (25%). According to endometriosis stage, the implantation rate and clinical pregnancy rate were significantly
lower
in stage Ⅳ (5.6%, 16%) compared with other stages (Ⅰ; 10.0%, 26%, Ⅱ; 9.8%, 31%, Ⅲ; 12.6%, 32%). It suggests that some factor like autoantibodies may inhibit implantation of embryos in stage Ⅳ endometriosis. To evaluate the possibility that
simply
increasing the number of gametes at the site of fertilization might account for pregnancies attributed to IVF-ET, the authors retrospectively analyzed the outcome of couples undergoing IUI during hMG cycles and CC cycles between 1992 and 1994 in
the
women with endometriosis stage Ⅰ. In case of stage Ⅰendometriosis, though the COH/IUI group showed lower FSH level and lesser age profile than IVF-ET group, IUI group has resulted in lower pregnancy rates (19.2%) compared with the IVF-ET group
(26.2%).
In conclusion, endometriotic infertile patients can get comparable pregnancy rates with the tubal factor infertility patients during IVF-ET program. Moreover even in stage Ⅰ endometriosis, IVF-ET may be an more effective treatment modality than
COH/IUI.
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