THE OUTCOME OF IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER THERAPY IN WOMEN WITH ENDOMETRIOSIS FAILING TO CONCEIVE AFTER LAPAROSCOPIC CONSERVATIVE SURGERY

Objective. To compare the outcome of in vitro fertilization and embryo transfer (IVF-ET) after laparoscopic surgery in women with endometrio sis with that of patients with tubal factor infertility. Design. Retro spective survey of hospital and office charts using a computerized wor ksheet. Setting. Lin-Kou medical center of Chang Gung Memorial Hospita l. Patients. Sixty-seven women with minimal to mild or moderate to sev ere endometriosis. Women with tubal factor infertility without other a ssociated disorders (60 cycles) made up the control group. Interventio ns. Seventy-five consecutive cycles of IVF-ET were performed in these patients who failed to conceive after laparoscopic conservative surger y. Measurements and Main Results. The concentration of serum estradiol on the day of human chorionic gonadotropin (hCG) injection, the day o f hCG injection, clinical pregnancy rates per transfer number of folli cles larger than 14 mm, number of embryos transferred and implantation rate were not significantly different between women with endometriosi s and those with tubal factor infertility. The number of oocytes retri eved and number fertilized were decreased, and the basal level of foll icle-stimulating hormone on cycle day 3 was higher in women with both degrees of endometriosis. Women in both endometriosis groups received more follicle-stimulating hormone and human menopausal gonadotropin th an those with tubal factor infertility. Conclusions. The outcome of IV F-ET in patients with endometriosis after laparoscopic surgery did not differ from that in the group with tubal factor infertility, but the former required more ampules of gonadotropin to achieve the same respo nse. The advantages of laparoscopic surgery in women with endometriosi s should be probably correlated with success of IVF-ET.