Does IVF Have an Impact on Endometriosis?
Most of this article has been devoted to a discussion of whether endometriosis and its treatments have an impact on IVF outcome. It is perhaps appropriate to also ask whether IVF and COH have an impact on the progression of endometriosis given the resulting supraphysiologic estradiol levels that could theoretically stimulate disease progression. There is a limited amount of data in this regard, but the results are reassuring.
D'Hooghe et al evaluated 67 patients with stage III/IV endometriosis who underwent ovarian stimulation after surgery for either IVF and/or IUI. Cumulative disease recurrence as calculated by life table analysis was lower after stimulation for IVF than for IUI cycles despite exposure to significantly higher circulating estradiol levels. Similarly, Benaglia and colleagues noted no worsening in endometriosis symptom scores or change in size of either endometriomas or peritoneal nodules evaluated by serial transvaginal ultrasound examinations in the 3 to 6 months after an IVF cycle. The authors reported that 22% reported improvement in symptoms, whereas 11% reported worsening of symptoms during this follow-up period.
Semin Reprod Med. 2013;31(2):154-163. © 2013 Thieme Medical Publishers