Cited by 375Endometriosis Research and TreatmentReproductive Biology and FertilityReproductive Health and Technologies

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Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation

Simón, C., Gutiérrez, A., Vidal, A., de los Santos, M.J., Tarín, J.J., Remohí, J., Pellicer, A.·1994·Human Reproduction

DOI 10.1093/oxfordjournals.humrep.a138578

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Abstract

A retrospective analysis of our in-vitro fertilization (IVF) and oocyte donation programmes was carried out in order to gain clinical knowledge of the factors involved in the aetiology of the endometriosis-associated infertility. Comparison between the IVF outcomes from 96 cycles in 78 patients with tubal infertility and from 96 cycles in 59 women with endometriosis indicates that endometriosis patients have a poor IVF outcome in terms of reduced pregnancy rate per cycle (P < 0.0004), reduced pregnancy rate per transfer (P < 0.002), and reduced implantation rate (P < 0.003). The analysis of patients undergoing oocyte donation for different reasons, including low response with or without endometriosis, showed that patients with this disease have the same chances of implantation and pregnancy as other recipients when the oocytes came from donors without known endometriosis. However, when the results of oocyte donation were classified according to the origin of the oocytes donated, patients who received embryos derived from endometriotic ovaries showed a significantly (P < 0.05) reduced implantation rate as compared to the remaining groups. Taken together, all these observations suggest that infertility in endometriosis patients may be related to alterations within the oocyte, which in turn result in embryos with decreased ability to implant.

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Self-citation
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BackgroundMethodInfluentialSelf-citation
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Background
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Background
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Background
Endometriosis does not affect live birth rates of patients submitted to assisted reproduction techniques: analysis of the Latin American Network Registry database from 1995 to 2011
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Background
Prolonged cyclical and continuous regimens of dydrogesterone are effective for reducing chronic pelvic pain in women with endometriosis: results of the ORCHIDEA study
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“in part, to lower oocyte quality (Díaz et al., 2000; Simón et al., 1994).”
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BackgroundResult
Endometriosis and infertility: The debate continues
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BackgroundResultInfluential
In Vitro Fertilization Success Rates after Surgically Treated Endometriosis and Effect of Time Interval between Surgery and In Vitro Fertilization.
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Influential
Live Birth After Oocyte Donation In Vitro Fertilization Cycles in Women With Endometriosis
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Characterizing the endometrial fluid cytokine profile in women with endometriosis
Llarena, N. C., Richards, E. G., Priyadarshini, A., Fletcher, D., Bonfield, T. L., & Flyckt, R. L. (2020) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-020-01989-y · Cited by 25
“Additionally, data from infertility patients shows that the endometrial cytokine profile is altered by ovarian stimulation for IVF [37], suggesting the potential for modulation of the endometrial environment through medical or surgical treatment of endometriosis.”
Background
Long-term use of gonadotropin-releasing hormone analogues before IVF in women with endometriosis
Tavmergen, E., Ulukuş, M., & Göker, E. N. T. (2007) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e3281053a52 · Cited by 21
Diagnostic significance of neutrophil to lymphocyte ratio in endometriosis: a systematic review and meta-analysis
Tabatabaei, F., Tahernia, H., Ghaedi, A., Bazrgar, A., & Khanzadeh, S. (2023) · BMC Women s Health · doi:10.1186/s12905-023-02692-7 · Cited by 26
“Research on oocyte donation indicates a negative impact on oocytes rather than endometrial receptivity [51].”
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Intracytoplasmic sperm injection (ICSI) in unexplained and stage I endometriosis-associated infertility after fertilization failure with in vitro fertilization (IVF)
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From conception to birth - how endometriosis affects the development of each stage of reproductive life.
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The Endometrioma Treatment Paradigm when Fertility Is Desired: A Systematic Review
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Assisted reproductive technology for women with endometriosis, a clinically oriented review
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“Although early studies using oocyte donation model [2] suggested that oocytes can be affected rather than endometrial receptivity, more recent observations yielded contradictory results.”
Result
Could surgical management improve the IVF outcomes in infertile women with endometrioma?: a review
Park, H. J., Kim, H. H., Lee, G. H., Yoon, T. K., & Lee, W. S. (2019) · Obstetrics & Gynecology Science · doi:10.5468/ogs.2019.62.1.1 · Cited by 23
Nontargeted metabolomics analysis of follicular fluid in patients with endometriosis provides a new direction for the study of oocyte quality
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Telocytes enhanced the proliferation, adhesion and motility of endometrial stromal cells as mediated by the ERK pathway in vitro.
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Influence of severe endometriosis on gene expression of vascular endothelial growth factor and interleukin-6 in granulosa cells from patients undergoing controlled ovarian hyperstimulation for in vitro fertilization-embryo transfer
Yamashita, Y., Ueda, M., Takehara, M., Yamashita, H., Suzuki, Y., Hung, Y., Terai, Y., & Ueki, M. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03339-3 · Cited by 22
Polymorphic variants of CYP 17 and CYP 19A and risk of infertility in endometriosis
Szczepańska, M., Wirstlein, P. K., Skrzypczak, J., & Jagodziński, P. P. (2013) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.12210 · Cited by 21
“women with endometriosis due to a disturbance in folliculogenesis, decreased fertilization, implantation defects, and poor oocyte quality with decreased blastocyst implantation ability (25,26).”
Background
Peritoneal Fluid From Infertile Women With Minimal/Mild Endometriosis Compromises the Meiotic Spindle of Metaphase II Bovine Oocytes: A Pilot Study
Jianini, B. T. G. M., Giorgi, V. S. I., Broi, M. G. D., de Paz, C. C. P., Silva, J. C. R. E., Ferriani, R. A., & Navarro, P. A. (2017) · Reproductive Sciences · doi:10.1177/1933719116687658 · Cited by 22
Endometriosis, Ovarian Reserve and Live Birth Rate Following In Vitro Fertilization/Intracytoplasmic Sperm Injection
Neto, M. A. C., Martins, W. P., da Luz, C. M., Jianini, B. T. G. M., Ferriani, R. A., & Navarro, P. A. (2016) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1055/s-0036-1584126 · Cited by 20
Anti-Laminin-1 Antibodies in Sera and Follicular Fluid of Women with Endometriosis Undergoing in Vitro Fertilization
Caccavo, D., Pellegrino, N. M., Totaro, I., Vacca, M. P., Selvaggi, L. E., & Depalo, R. (2011) · International Journal of Immunopathology and Pharmacology · doi:10.1177/039463201102400221 · Cited by 20
“Concerning the relationship between oocyte quality and endometriosis-associated infertility, alterations within oocyte, resulting in embryos with decreased ability to implant has been suggested as a possible cause of reproductive failure (23).”
Background
The relevance of the peritoneal fluid in endometriosis-associated infertility
Mülayim, N., & Arici, A. M. (1999) · Human Reproduction · doi:10.1093/humrep/14.suppl_2.67 · Cited by 20
“…the oocytes of endometriosis patients (Wardle et al., 1985, 1986), more recent studies have found that endometriosis has no effect on oocyte quality, fertilization, and pregnancy rates in patients undergoing assisted reproduction (Braeckmans et al., 1987; Simon et al., 1994; Arici et al., 1996a).”
BackgroundInfluential
Hydrosalpinx: Tubal surgery or in vitro fertilisation? An everlasting dilemma nowadays; a narrative review
Daniilidis, A., Balaouras, D., Chitzios, D., et al. (2017) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2017.1287685 · Cited by 19
“…tubal factor infertility Several studies have indicated that embryo quality and implantation rate were decreased in infertile women with endometriosis undergoing IVF, however, endometrial receptivity appeared not to be affected (Simon et al. 1994; Garcia-Velasco et al. 2001; Garrido et al. 2002).”
Background
Oocyte Cryopreservation in Patients with Endometriosis: Current Knowledge and Number Needed to Treat
Henry, L., Vervier, J., Boucher, A., Brichant, G., Gaspard, O., Labied, S., Munaut, C., Ravet, S., & Nisolle, M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11154559 · Cited by 20
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“Though lower implantation rates in the setting of endometriosis have been reported in multiple clinical studies [13, 14], the relative contribution of embryo quality and endometrial receptivity to this finding can be debated.”
Background
Early Pregnancy Outcomes in Fresh Versus Deferred Embryo Transfer Cycles for Endometriosis-Associated Infertility: A Retrospective Cohort Study
Tan, J., Cerrillo, M., Cruz, M., Cecchino, G. N., & García-Velasco, J. A. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10020344 · Cited by 19
“Indeed, [25] observed that women with endometriosis who received donor oocytes achieved similar pregnancy outcomes compared to women with other causes of infertility, while donor recipients who received oocytes from women with endometriosis experienced significantly lower implantation rates (p < 0.”
Result
Follicular-fluid anti-Müllerian hormone concentration is similar in patients with endometriosis compared with non-endometriotic patients
Campos, C. S., Vaamonde, D., Andreoli, C., Martins, A. C., Genro, V. K., de Souza, C. A. B., Chapon, R. D. C. B., & Cunha‐Filho, J. S. (2010) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2010.05.007 · Cited by 18
“Studies on oocyte donation have demonstrated that embryos from patients with endometriosis had lower implantation rates (Simon et al., 1994).”
Background
Live-Birth Outcomes and Congenital Malformations After Progestin-Primed Ovarian Stimulation in Maternal Endometriosis
Zhou, L., Wang, Y., & Kuang, Y. (2020) · Drug Design Development and Therapy · doi:10.2147/dddt.s263138 · Cited by 18
MicroRNA22-5p targets ten-eleven translocation and regulates estrogen receptor 2 expression in infertile women with minimal/mild endometriosis during implantation window
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Transcriptomic analysis of cumulus cells shows altered pathways in patients with minimal and mild endometriosis
da Luz, C. M., Broi, M. G. D., Koopman, L. D. O., Plaça, J. R., Silva, W. A., Ferriani, R. A., Meola, J., & Navarro, P. A. (2022) · Scientific Reports · doi:10.1038/s41598-022-09386-4 · Cited by 16
Diagnosis and treatment of endometriosis
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Endometriosis and In Vitro Fertilization
Latif, S., Khanjani, S., & Sarıdoğan, E. (2024) · Medicina · doi:10.3390/medicina60081358 · Cited by 22
Hox Genes in Adult Tissues and Their Role in Endothelial Cell Differentiation and Angiogenesis
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The gene expression profile of cumulus cells reveals altered pathways in patients with endometriosis
Allegra, A., Raimondo, S., Volpes, A., Fanale, D., Marino, A. A., Cicero, G., Leo, G. D., Sammartano, F., Allegra, G., & Alessandro, R. (2014) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-014-0305-1 · Cited by 15
“On the contrary, the oocytes retrieved by donors with endometriosis led to a statistically significant decrease in pregnancy rates in recipients, thereby demonstrating a direct effect of endometriosis on oocyte and embryo quality rather than on endometrial receptivity [7].”
Background
Laparoscopic Treatment of Endometrioma-Associated Infertility and Pregnancy Outcome
Takuma, N., Sengoku, K., Pan, B., Wada, K., Yamauchi, T., Miyamoto, T., Ohsumi, D., & Ishikawa, M. (2002) · Gynecologic and Obstetric Investigation · doi:10.1159/000066292 · Cited by 15
The Effect of Surgery on Endometriomas on Fertility (2025 Second Edition)
Supramaniam, P. R., Mittal, M., Becker, C. M., & Jayaprakasan, K. (2025) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.18221 · Cited by 14
“Nevertheless, the European Society of Human Reproduction and Embryology (ESHRE) guideline for the management of endometriosis [29], published 20 years after Simón et al. [52], has not identified such differences.”

Authors: Simón, C., Gutiérrez, A., Vidal, A., de los Santos, M. J., Tarín, J. J., Remohí, J., & Pellicer, A.
Affiliations: Universitat de València (ES)
ORCID: Simón, C.
Tarín, J.J.
Pellicer, A.
Venue: Human Reproduction
Publisher: Oxford University Press (OUP)
Published: 1994-04
Volume: 9
Issue: 4
Pages: 725-729
ISSN: 0268-1161 (ISSN-L)
1460-2350
DOI: 10.1093/oxfordjournals.humrep.a138578
OpenAlex: W2151618269
Cited by: 374
References: 0
Citations by year: 2026: 5 · 2025: 10 · 2024: 14 · 2023: 18 · 2022: 12 · 2021: 14 · 2020: 14 · 2019: 17 · 2018: 11 · 2017: 18 · 2016: 12 · 2015: 14 · 2014: 13 · 2013: 14 · 2012: 19
FWCI: 7.91
Type: journal article
Language: en
Open access: closed
Locations: Human Reproduction (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords: endometriosis, endometriosis-associated infertility, IVF outcomes, oocyte donation, tubal infertility, implantation rate, oocyte quality
MeSH terms: Adult, Embryo Transfer, Endometriosis, Female, Fertilization in Vitro, Humans, Infertility, Female, Oocytes, Embryo Implantation, Pregnancy, Retrospective Studies, Tissue Donors

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Outcome of patients with endometriosis in assisted reproduction: results from in-vitro fertilization and oocyte donation

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