Is the endometriosis recurrence rate increased after ovarian hyperstimulation?
Open accessAbstract
Objective To test the hypothesis that the cumulative endometriosis recurrence rate (CERR) after fertility surgery for endometriosis stage III or IV is increased in women exposed to very high E(2) levels during ovarian hyperstimulation (OH) for IVF when compared with women exposed to less high E(2) levels during OH for intrauterine insemination (IUI). Design Retrospective cohort study including infertility patients with endometriosis stage III or IV. Setting Leuven University Fertility Center, between 1990 and 2001. Patient(s) Patients (n = 67) with endometriosis stage III (n = 45) or IV (n = 22) who underwent pelvic reconstructive surgery and subsequently started fertility treatment with either IVF only (n = 39), both IVF and IUI in different cycles (n = 11), or IUI only (n = 17). Intervention(s) Life table analysis was used to calculate the CERR. Main outcome measure(s) The CERR based on histologic or cytologic proof of disease recurrence. Result(s) At 21 months after the start of OH the overall CERR was 31% and was significantly lower in patients treated with IVF only (7%) or women treated with both IVF and IUI in different cycles (43 %) than in those treated with IUI only (70%). At 36 months after the start of OH, the overall CERR was 63%. Conclusion(s) In contrast to our hypothesis, the results from this study showed that the CERR is lower after ovarian hyperstimulation for IVF than after lower-dose ovarian stimulation for IUI, suggesting that temporary exposure to very high E(2) levels in women during OH for IVF is not a major risk factor for endometriosis recurrence in women treated with assisted reproductive technology.
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The risk of endometriosis recurrence appears to be increased by IUI and was reported to be higher than after IVF.
“Lastly, the risk of endometriosis recurrence appears to be increased by IUI (Van der Houwen et al., 2014) and was reported to be higher than after IVF D’Hooghe et al., (2006).”
From When more is not better: 10 ‘don’ts’ in endometriosis management. An ETIC* position statement (2019) · cites this paper as D’Hooghe et al., (2006)
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- Authors
- D’Hooghe, T. M., Denys, B., Spiessens, C., Meuleman, C., & Debrock, S.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Corresponding author
- D’Hooghe, Thomas M.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2006-08
- Volume
- 86
- Issue
- 2
- Pages
- 283-290
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2077207180
- Cited by
- 112
- References
- 21
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 5 · 2020: 5 · 2019: 13 · 2018: 10 · 2017: 10 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 8 · 2012: 5
- FWCI
- 6.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- endometriosis recurrence, ovarian hyperstimulation, in vitro fertilization, intrauterine insemination, pelvic reconstruction, assisted reproduction, infertility
- MeSH terms
- Adult, Endometriosis, Estradiol, Female, Fertilization in Vitro, Follow-Up Studies, Humans, Infertility, Female, Insemination, Artificial, Ovulation Induction, Recurrence, Retrospective Studies, Cohort Studies, Life Tables, Incidence, Plastic Surgery Procedures
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