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20B - Endometriosis Should Be Suppressed for 6–12 Weeks before Frozen Embryo Transfer

Against

from Section III - The Best Policy

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Endometriosis-associated infertility is a common indication for in vitro fertilisation (IVF) treatment. There is great controversy regarding the outcome of IVF in such patients. Possibly inferior results compared with other indications for IVF are likely based on reduced oocyte and embryo quality and not adverse endometrial receptivity. Such knowledge is based on IVF crossover studies with donor oocytes and patient’s own oocytes to women with and without endometriosis. Embryos that are frozen and later thawed for transfer to the uterus are selected among the best embryos in a fresh cycle. Transfer of such embryos is as successful in endometriosis as in other causes of infertility whatever endometrial preparation is used. Thus, long-term suppression of endometriosis with GnRH agonists in frozen embryo transfer is unnecessary and may possibly be harmful due to induction of endometritis.

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Publisher: Cambridge University Press
Print publication year: 2021

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References

Georgiou, EX, Melo, P, Baker, PE, et al. Long-term GnRH agonist therapy before in vitro fertilisation (IVF) for improving fertility outcomes in women with endometriosis. Cochrane Database Syst Rev. 2019;11:CD013240.Google Scholar
Senapati, S, Sammel, MD, Morse, C, Barnhart, KT. Impact of endometriosis on in vitro fertilization outcomes: an evaluation of the Society for Assisted Reproductive Technologies Database. Fertil Steril. 2016;106:164–71.e1.CrossRefGoogle Scholar
Ghobara, T, Gelbaya, TA, Ayeleke, RO. Cycle regimens for frozen-thawed embryo transfer. Cochrane Database Syst Rev. 2017;7:CD003414.Google ScholarPubMed
Roque, M, Haahr, T, Geber, S, Esteves, SC, Humaidan, P. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Hum Reprod Update. 2019;25:214.CrossRefGoogle ScholarPubMed
Khan, KN, Fujishita, A, Hiraki, K, et al. Bacterial contamination hypothesis: a new concept in endometriosis. Reprod Med Biol. 2018;17:125–33.CrossRefGoogle ScholarPubMed

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