Preterm birth, ovarian endometriomata, and assisted reproduction technologies

Objective: To report preterm birth and small for gestational age (SGA) rates from assisted reproduction technologies (ART) patients with ovarian endometriomata compared with control groups. Design: Retrospective cohort study. Setting: Tertiary university affiliated ART center and Perinatal Data Collection Unit (PDCU). Patient(s): Every woman who had an ART singleton baby born between 1991 and 2004 had her database record assessed (N = 4382). Control groups included 1201 singleton babies from ART patients without endometriosis and 2400 randomly selected women from the PDCU database of 850,000 births. Intervention(s): There were 95 singleton ART babies from patients with ovarian endometriomata and 535 ART singleton babies from patients who had endometriosis but no ovarian endometriomata. Main Outcome Measure(s): Preterm birth rates and SGA birth rates. Result(s): Preterm birth rate increased only in the ovarian endometriomata group when compared with community birth records (n = 850,000). Furthermore, ART patients with ovarian endometriomata had a statistically significantly increased likelihood of having a SGA baby when compared with other forms of endometriosis. Conclusion(s): Rates of preterm birth and SGA babies doubled in infertility patients with ovarian endometriomata who required ART. (Fertil Steril (R) 2009;91:325-30. (C)2009 by American Society for Reproductive Medicine.)