Endometriosis severity affects IVF outcome

November 2005

Women with moderate-to-severe endometriosis are less likely to fall pregnant and have a baby with the help of IVF than those with minimal-to-mild disease, researchers have shown, according to Finish researchers.

“Women with endometriosis often need IVF to conceive—most women need several cycles of treatment,” note the researchers, led by Paula Kuivasaari from Kuopio University Hospital in Finland.

To investigate the impact of endometriosis severity on IVF outcome, they followed-up 31 women with stage I/II (minimal-to-mild) endometriosis and 67 with stage III/IV (moderate-to-severe) disease who underwent IVF or ICSI, along with a reference group of 87 women who had tubal infertility.

The pregnancy rate per embryo transfer was significantly lower for women with stage III/IV endometriosis than for those with stage I/II disease or for the controls (22.6 percent vs 40.0 percent and 36.6 percent, respectively). However, after 1-4 cycles, 56.7 percent of women in the stage III/IV group were pregnant and 40.3 percent had given birth, compared with 67.7 percent and 55.8 percent of those in the stage I/II group, respectively, and 81.6 percent and 43.7 percent of controls.

The authors commented that it is “obvious” from their data that the success of IVF decreased with increasingly severe endometriosis, but also point out that “the overall cumulative outcome of IVF/ICSI treatment was favorable.”

They add: “Pregnancies in women with endometriosis more often resulted in live-born infants than those in the tubal factor group.”


Kuivasaari P, Hippelainen M, Anttila M, Heinonen S. Effect of endometriosis on IVF/ICSI outcome: stage III/IV endometriosis worsens cumulative pregnancy and live-born rates. Human Reproduction 2005; 20: 3130-5.

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