Impact of Endometriosis Surgery on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes: a Systematic...

Area of Science:

• Reproductive Medicine
• Surgical Gynecology

Background:

• Endometriosis-associated infertility presents significant challenges in reproductive medicine.
• The efficacy of pre-assisted reproductive technology (ART) surgery on reproductive outcomes remains a critical research question.

Approach:

• A systematic review and meta-analysis compared live birth rates (LBR) and ongoing pregnancy rates (OPR) in patients undergoing endometriosis surgery before ART (IVF/ICSI) versus first-line ART.
• Searches covered January 1990 to June 2021 across major databases (PubMed, Embase, Cochrane Library).

Key Points:

• Overall, no statistically significant differences in LBR, OPR, or early pregnancy loss rates were observed between groups.
• After excluding studies with high risk of bias, LBR per cycle was significantly reduced following pre-ART surgery.
• These findings suggest potential negative impacts of surgery on live birth rates.

Conclusions:

• Clinicians must carefully evaluate the benefits and risks of pre-ART surgery for infertile patients with endometriosis.
• Multidisciplinary referral centers play a crucial role in managing these complex cases.