Oocyte vitrification for fertility preservation in women with endometriosis: an observational study

To describe the outcome of fertility preservation (FP) using vitrified oocytes in patients with endometriosis and to determine the impact of ovarian surgery. Retrospective observational study. University-affiliated private in vitro fertilization (IVF) center. Four hundred and eighty-five women with...

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Bibliographic Details
Published in:Fertility and sterility 2020-04, Vol.113 (4), p.836-844
Main Authors: Cobo, Ana, Giles, Juan, Paolelli, Stefania, Pellicer, Antonio, Remohí, José, García-Velasco, Juan Antonio
Format: Article
Language:English
Subjects:
Endometrioma
endometriosis
fertility preservation
oocyte vitrification
ovarian surgery
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Summary:To describe the outcome of fertility preservation (FP) using vitrified oocytes in patients with endometriosis and to determine the impact of ovarian surgery. Retrospective observational study. University-affiliated private in vitro fertilization (IVF) center. Four hundred and eighty-five women with endometriosis who underwent FP from January 2007 to July 2018. Vitrification of metaphase II (MII) oocytes for future use. Oocyte survival rate and cumulative live-birth rate (CLBR). Mean age at vitrification was 35.7 ± 3.7 years. The women undergoing operations were younger than the nonsurgical patients (33.4 ± 3.6 years vs. 36.7 ± 3.7 years). The survival rate and CLBR were 83.2% and 46.4%, respectively. The number of vitrified oocytes per cycle (6.2 ± 5.8) was higher for the nonsurgical patients compared with the unilateral (5.0 ± 4.5) or bilateral (4.5 ± 4.4) surgery groups, but was comparable among the surgical patients. The effect of age (adjusted odds ratio [OR] 0.904; 95% CI, 0.858–0.952), number of oocytes (adjusted OR 1.050; 95% CI, 1.025–1.091), and survival (adjusted OR 1.011; 95% CI, 1.001–1.020) on the CLBR was confirmed. However, the effect of surgery was not observed (adjusted OR 1.142; 95% CI, 0.778–1.677). Nonetheless, the ovarian response (vitrified oocytes = 8.6 ± 6.9 vs. 5.1 ± 4.8) and CLBR (72.5% vs. 52.8%) were higher in young (≤35 years) nonsurgical patient versus the surgical patients; older women showed similar outcomes. Fertility preservation gives patients with endometriosis a valid treatment option to help them increase their reproductive chances. We suggest performing surgery after ovarian stimulation for FP in young women. In older women, an individualized treatment should be considered. Vitrificación de ovocitos para preservar la fertilidad en mujeres con endometriosis: un estudio observacional Describir el resultado de la preservación de la fertilidad (PF) utilizando ovocitos vitrificados en pacientes con endometriosis y determinar el impacto de la cirugía ovárica. Estudio observacional retrospectivo. Centro privado de fecundación in vitro (FIV) afiliado a la universidad. Cuatrocientas ochenta y cinco mujeres con endometriosis que se sometieron a PF desde enero de 2007 hasta julio de 2018 Vitrificación de ovocitos en metafase II (MII) para uso futuro. Tasa de supervivencia ovocitaria y tasa acumulada de nacidos vivos (CLBR). La edad media de vitrificación fue de 35,7 ± 3,7 años. Las mujeres sometidas a operaciones eran más jóvene
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2019.11.017