Benefit of in vitro fertilization treatment for endometriosis-associated infertility

Objective: To evaluate the effectiveness of IVF treatment in endometriosis-associated infertility. Design: Nonrandom retrospective study. Setting: Department of Gynecology and Obstetrics, Akita University School of Medicine. Main Outcome Measure(s): Cumulative pregnancy rate. Patient(s): One hundred eighteen infertile patients in whom diagnosis of endometriosis was established by laparoscopic examination. Intervention(s): The prognoses of 60 patients (IVF group) who started IVF treatment within 6 months after laparoscopy were compared with those of 58 patients who were managed expectantly without IVF treatment during the same period. Result(s): The cumulative conception rates at 36 months after laparoscopy were 62% in the IVF group and 43% in the control group, and the difference was not significant (a log-rank test). For patients greater than or equal to 32 years of age, the conception rates were significantly higher in the IVF group (59% versus 29%). A relatively large but nonsignificant difference in the conception rate between the two groups was observed in patients with endometriosis at stages III or IV (52% versus 27%). Conclusion(s): In vitro fertilization treatment provides better prognosis in patients greater than or equal to 32 years of age and is recommended for such patients. The benefits of treatment appear to be greater in patients with more advanced stages of endometriosis.