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Endometriosis impairs the efficacy of gamete intrafallopian transfer: results of a case-control study
D S Guzick1, Y A Yao, S L Berga
1Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pennsylvania.
Objective:
To determine whether pelvic endometriosis impairs the efficacy of GIFT.
Design:
Matched follow-up study.
Setting:
University-based assisted reproduction program.
Participants:
Patients undergoing GIFT between 1987 and 1991. Cases had a primary diagnosis of endometriosis. Controls had no endometriosis and were matched with cases according to age, number of mature eggs transferred, and sperm grade.
Intervention:
Gamete intrafallopian transfer was performed in all patients in an identical manner independent of their underlying diagnosis.
Main Outcome Measures:
Pregnancy and delivery rates.
Results:
Of 114 laparoscopic egg retrievals performed in the endometriosis group, there were 37 pregnancies (32.5%) and 27 deliveries (23.7%). Of the 214 retrievals in the control group, there were 101 pregnancies (47.2%) and 76 deliveries (35.5%). Mantel-Haenszel estimates of relative risk indicated that endometriosis significantly impaired pregnancy and delivery rates. There was no statistically significant difference in pregnancy rates according to severity of disease among endometriosis cases. There was no statistically significant difference in pregnancy rates according to severity of disease among endometriosis cases.
Conclusions:
Our finding that GIFT pregnancy rates were lower in women with a primary diagnosis of endometriosis than in matched controls suggests that endometriosis is associated with reduced efficacy of GIFT.