Dados do Trabalho

Title

Endometriosis does not affect Antral follicle responsiveness to follicle stimulating hormone administration in patients undergoing to IVF

Objective

The main objective of this research is to investigate if the presence of endometriosis in patients undergoing IVF affects the Antral Follicle responsiveness to exogenous gonadotropins for controlled ovarian stimulation.

Methods

We retrospectively studied 806 patients submitted to IVF with 24 - 45 years of age, during 2015-22. All of the studied patients met the following inclusion criteria: (i) both ovaries present, with no morphological abnormalities (such as cysts, endometriomas, etc.), no history of past surgery and adequately visualised in transvaginal ultrasound scans; (ii) regular menstrual cycle lengths ranging between 25 and 35 days; (iii) no current or past diseases affecting ovaries or gonadotrophin or sex steroid secretion, clearance or excretion; (iv) no clinical signs of hyperandrogenism; (v) BMI ranging from 16 to 30 kg/m2. Recombinant FSH therapy was then initiated, at an individual dosage according to the physician’s option and continued until the day of hCG administration. From the 6th day of recombinant FSH therapy onwards, daily FSH doses were adjusted according to the number of growing follicles and GnRH antagonist was administered. The main outcome was determined by the Follicular Output RaTe (FORT) that was calculated by the ratio between Peri-ovulatory Follicular Count on day-hCG × 100/Antral Follicular Count at baseline. We compared endometriosis x non-endometriosis patients in terms of baseline and some reproductive outcomes. P was considered significant when < 5%.

Results

The mean age of the patients was (mean ± SD) 35.1 ± 4 for endometriosis and 35.3 ± 5 for the control group, p=0.722. Moreover, AMH (3.88±3.4 versus 3.45±3.3), AFC (10±5 versus 11±6), and the number of mature oocytes (3.6±2 versus 3.9±3) were similar between both groups (p>0.05). Furthermore, the responsiveness to gonadotropin measured by FORT was also similar between endometriosis and non-endometriosis: 43% x 42.9%, p=0.957.

Conclusion

Endometriosis did not affect the follicular responsiveness to follicle-stimulating hormone during controlled ovarian stimulation for IVF. Moreover, some reproductive outcomes after COS were also similar between both groups.

Keywords

endometriosis, FORT, ovarian stimulation, IVF.