The Impact of Endometrioma on Embryo Quality in In Vitro Fertilization: A Retrospective Cohort Study.

The influence of endometrioma on oocyte and embryo competence is inconclusive. Furthermore, the benefits of surgical treatment remain uncertain. This study aimed to investigate the effect of endometrioma on oocyte and embryo quality from a morphological perspective and further explore whether surgery could contribute to improving oocyte and embryo competence. A total of 664 IVF cycles with endometrioma (538 cycles underwent surgeries) and 3133 IVF cycles from the control group were included. The propensity score matching was used to balance the baseline differences between groups. There was a lower MII oocyte rate (85.0% versus 87.8%, p < 0.001; 84.9% versus 87.6%, p = 0.001) and a similar good-quality embryos rate in women with endometrioma (and those who underwent surgeries) compared with control group. For women with endometrioma, the rates of blastocyst development (67.1% versus 60.2%; p = 0.013) and good blastocyst development (40.7% versus 35.2%; p = 0.049) were significantly higher in those who had undergone surgical treatment compared with those who had not, but the rates of MII oocytes (79.9% versus 87.7%; p < 0.001) and normal fertilization (55.2% versus 66.2%; p < 0.001) were lower. The study indicates that endometrioma, including its surgical treatment, compromises the oocyte maturity not the embryo quality at the cleavage stage; however, the surgery seems to contribute to improving blastocyst development.

Pregnancy outcomes after fresh versus vitrified-warmed embryo transfer in women with adenomyosis: a retrospective cohort study.

RESEARCH QUESTION: Is the singleton live birth rate superior for vitrified-warmed versus fresh embryo transfer in women with adenomyosis? DESIGN: This cohort study retrospectively analysed data from the Reproductive Hospital Affiliated to Shandong University between January 2013 and December 2018. A total of 612 women diagnosed with adenomyosis, with 322 fresh embryo transfer cycles and 290 vitrified-warmed embryo transfer cycles, were included in this study. The primary outcome was singleton live birth. Outcomes were adjusted using multivariable logistic regression analysis. RESULTS: Vitrified-warmed embryo transfer was associated with a higher rate of singleton live birth than fresh embryo transfer (25.9% versus 17.4%; P = 0.011). Although there was a trend towards a lower miscarriage rate after vitrified-warmed embryo transfer, the difference did not reach statistical significance (31.3% versus 40.6%; P = 0.111). The clinical pregnancy rate was comparable in the two groups (44.1% versus 44.4%; P = 0.946). Vitrified-warmed embryo transfer also resulted in a lower risk of preterm birth than fresh embryo transfer (7.0% versus 17.5%; P = 0.010). CONCLUSIONS: Vitrified-warmed embryo transfer may be associated with better pregnancy outcomes than fresh embryo transfer among women with adenomyosis. It seems that vitrified-warmed embryo transfer is more appropriate for specific populations.

The Impact of Endometriosis on Embryo Quality in in-vitro Fertilization/Intracytoplasmic Sperm Injection: A Systematic Review and Meta-Analysis.

Background: The association between endometriosis and embryological outcomes remains uncertain. The meta-analysis aimed to evaluate the impact of endometriosis on embryo quality. Methods: A systematic review and meta-analysis was conducted to investigate the association between the endometriosis and embryo quality. Searches were performed on the three electronic databases: PubMed, EMBASE, and Web of Science. The detailed characteristics and data of the included studies were extracted. The risk ratio with 95% confidence intervals were calculated using the random and fixed effects model. The main outcome measures were high-quality embryo rate, cleavage rate, and embryo formation rate. Results: A total of 22 studies included were analyzed. Compared with the control group, women with endometriosis had a similar high-quality embryo rate (RR = 1.00; 95% CI, 0.94-1.06), a comparable cleavage rate (RR = 1.00; 95% CI, 0.97-1.02), and a similar embryo formation rate (RR = 1.10; 95% CI, 0.97-1.24). In women with stage III-IV endometriosis, there was no statistically significantly difference in high-quality embryo rate (RR = 1.02; 95% CI, 0.94-1.10), cleavage rate (RR = 1.00; 95% CI, 0.98-1.02), and embryo formation rate (RR = 1.05; 95% CI, 0.97-1.14), compared with those without endometriosis. For women with unilateral endometrioma, pooling of results from the affected ovaries did not show a statistically significantly difference in high-quality embryo rate (RR = 0.99; 95% CI, 0.60-1.63) in comparison to the normal contralateral ovaries. Conclusions: Our results seem to indicate that endometriosis does not compromise embryo quality from the perspective of morphology.