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Early Embryo Development in Women with Endometriosis: A Retrospective Cohort Study


 Background: Endometriosis is known to be detrimental to fertility in many ways. Evidence drawn from studies on oocyte recipient cycles suggests that the oocyte quality of women with endometriosis is compromised. Research that specifically examined the association between embryo quality and endometriosis/endometrioma are scarce and the question if endometriosis affects oocyte and/or embryo quality remain controversial. This study aims to evaluate embryo quality of women with endometriosis (EN) and without endometriosis (tubal factor [TF], unexplained infertility [UE]).Methods: Multi-centre retrospective study was performed. Treatment cycles and embryology records of women with and without endometriosis undergoing IVF was reviewed via IDEASTM database. Number of oocytes collected per mature follicle, fertilisation rate, pregnancy rate, morphology and morphometric assessment of embryo at all stages were evaluatedResults: Total of 678 women who had IVF treatment was analysed (EN, n=89; TF, n=214; UE, n=375). The mean age for each group was EN, 34.4±3.3; TF, 33.5±3.7 and 34.6±3.2 respectively. Number of mature follicles (>14mm) on the day of trigger injection was similar (P=0.75) between all groups. Percentage of oocytes collected per mature follicle was lower in endometriosis compared to other groups (P=0.01; EN, 65±23; TF, 76±20; UE, 71±24). Higher percentages of embryos fail to achieve 8-cell stage in EN compared to control groups (P=0.02; EN, 4.0±1.6 TF, 1.2±0.4; UE, 1.5±0.4. Percentages of embryos at all grades (Grade1-4) per women were similar between the comparison groups (P>0.05). Endometriosis did not impair (P>0.05) blastocyst development or the development of Fully Expanded Hatching Blastocysts (FEHB).Conclusions: This study finds women with endometriosis have lower number of oocyte per total number of follicle. The presence of endometriosis is associated with a higher rate of early embryo arrest, which implicates poor oocyte quality. However endometriosis has no effect on the embryo quality beyond the 8-cell-stage of embryo development