When a woman suffers from endometriosis, this disease will affect one-tenth of the childbearing age, so in many cases, it is necessary to resort to assisted reproductive technology to achieve the purpose of pregnancy. The anatomical changes caused by this pathology can prevent spontaneous pregnancy in most cases.
Endometriosis is characterized by the appearance of endometrial cells outside the uterine cavity (ovaries, tubes, peritoneum, etc.), which have the ability to survive and escape natural defense mechanisms, and natural defense mechanisms should prevent them from being in these atypical areas The presence.
In the past decade, oocyte vitrification has allowed the development of maternity protection programs. Therefore, the number of vitrified oocytes and the age of the patient are key factors for successful reproduction. But what is the appropriate number for vitrification in these patients to optimize the chances of success?
This research aims to help fertility specialists and endometriosis patients establish realistic expectations for the chances of reproductive success based on their vitrified oocytes.
Ana Cobo, gynecologist
Ana Cobo, Director of the Cryopreservation Department of the Valencian Infertility Institute (IVI),show on New research As the number of patients’ oocytes increases, how will their chances of success increase? Therefore, in patients with endometriosis under the age of 35, about 20 oocytes have been successfully removed with a 95% success rate, while in people over 35, the maximum newborn rate is close to 80%.
“Previously, these data were known to women who preserved fertility and cancer patients, but for endometriosis patients, this information does not exist because of the risk of preterm birth in endometriosis patients. Higher, so the problem becomes more relevant. Ovarian reserve”, Kobo explained.
He added: “The purpose of this research is to help fertility specialists and endometriosis patients establish realistic expectations about their chances of successful reproduction based on their vitrified oocytes.”
The importance of age
This work includes data from 485 women with endometriosis who maintained fertility in IVI clinics across Spain between January 2007 and July 2018, and later tried to get pregnant.
“These findings clearly show that young people have a beneficial effect on the reproductive outcome of women with endometriosis who maintain fertility; however, we must pay special attention to women with advanced disease or women who need surgical treatment.”, Experts pointed out.
“Although it is true that for young women, it is relatively easy to obtain the maximum number of 15-20 oocytes for vitrification (perhaps in two stimulation cycles), but for patients with impaired ovarian reserve, this may even be It will become more difficult, which may be more difficult. If the patient has undergone surgery, continue.
It is true that it is relatively easy to obtain the maximum number of 15-20 oocytes for vitrification in young women, but it may be more difficult in patients with impaired ovarian reserve (such as patients with endometriosis).
The effect of surgery on ovarian reserve
An earlier study, also led by Cobo, revealed how young women perform better after vitrifying their oocytes to maintain fertility before surgical removal of endometrioma of the ovary.
Surgery has a quantitative effect on ovarian reserve. Experts concluded that after surgery, the number of recovered oocytes will be reduced, which may have a negative impact on the chance of pregnancy in the future.
Ana Cobo, Aila Coello, María José de los Santos, Juan Giles, Antonio Pelise (Antonio Pellicer), José Remohí, Juan A. García Velasco (Juan A. The number required for freezing: the cumulative live birth rate of patients with endometriosis after retaining fertility. Reproductive Biomedicine Online, 2021.