Investigating Unilateral Ovarian Endometrioma's Effect on Ova and Embryo Quality in 409 Infertile Endometriotic Patients.

PURPOSE: In women with unilateral endometriosis, how do ovarian endometriomas and their inflammatory content affect oocyte and embryo quality in affected versus healthy ovaries, and what is the impact on ART outcomes?

METHODS

This study, conducted from March 2022 to March 2024 at Shiraz University of Medical Sciences, assessed infertility outcomes in patients with unilateral endometriomas. It analyzed reproductive parameters (total follicles, oocytes, and embryos quantity and quality) from affected and healthy ovaries, while considering endometrioma size and AMH levels.

RESULTS

This study analyzed ovum pickups and ART outcomes in 409 women with unilateral ovarian endometriosis, revealing critical insights into reproductive performance. Participants had an average age of 33.55 years and a basal AMH level of 2.26 ng/dL, categorized into poor (25.2%), normal (57.2%), and high (17.6%) responders based on their AMH levels. Comparison of outcomes showed that healthy ovaries yielded significantly more MII oocytes, total embryos, and Grade C embryos than affected ovaries, although no significant differences were found across various endometrioma sizes regarding follicular development and egg/embryo quality (p > 0.05). Notably, the good responder group outperformed others in terms of GV oocytes, MII oocytes, and total embryos retrieved. Ultimately, among 40 embryo transfers conducted, 21 resulted in successful pregnancies (52.5%).

CONCLUSION

Endometriomas lead to fewer M2, total fertilization rate. However, embryo quality remains unchanged. Future studies should compare ART outcomes in operated and non-operated ovaries and assess deep infiltrating endometriosis's impact on egg quality and quantity.