Impact of stage III-IV endometriosis on recipients of sibling oocytes: matched case-control study.

OBJECTIVE

To evaluate the impact of severe endometriosis on IVF-ET outcome in women receiving oocytes from the-same donor.

DESIGN

A matched case-control study.

SETTING

Oocyte donation program at the Instituto Valenciano de Infertilidad.

PATIENT(S): Fifty-eight recipients were included in a matched case-control study of IVF-ET in our oocyte donation program. Twenty-five patients were diagnosed by laparoscopy with stage III-IV endometriosis (group I), while the remaining 33 were free of the disease (group II). On the day of retrieval, oocytes from a single donor were donated to recipients from both groups. Some of the donors supplied oocytes for more than 2 patients. Recipients received steroid replacement therapy for endometrial preparation.

INTERVENTION(S): Ovarian stimulation and oocyte retrieval in donors. Uterine embryo transfer (ET) in recipients after appropriate exogenous hormone replacement therapy (HRT).

MAIN OUTCOME MEASURE(S): Pregnancy, implantation, miscarriage, and live birth rates.

RESULT(S): The number of oocytes donated and fertilized, as well as the number of available and transferred embryos, was not statistically different between the two groups. Pregnancy, implantation, and miscarriage rates were not affected by stage III-IV endometriosis when compared with the control group. The live birth rate was 28.0% in the group with endometriosis and 27.2% in the control group.

CONCLUSION(S): These results show that implantation is not affected by stage III-IV endometriosis. Given the contemporary methods of endometrial preparation for transfer of embryos derived from donor oocytes, any potential negative effect of severe endometriosis on the uterine environment is undetectable.