Infertility Treatments

Do Women With Endometriosis Produce Normal Embryos?

Do Women With Endometriosis Produce Normal Embryos?

Many questions arise about fertility in women with endometriosis, including whether it lowers the chance of conception during natural conception as well as IVF. Additionally, patients often ask “do women with endometriosis produce normal embryos?” Certainly, advanced stage endometriosis is associated with lower fertility rates during natural conception. In women with minimal-mild endometriosis the answer is not clear. However, many studies have shown that in patients with minimal, mild, and advanced endometriosis, IVF will significantly increase the chance of pregnancy. Many questions remain about women with endometriosis and their chance of success with IVF.

Do Women With Endometriosis Have Lower IVF Success Rates?

In a recent blog, I reviewed a very encouraging study that the lining of the uterus in women with endometriosis appears to be as receptive to a pregnancy and live birth compared with women with other infertility and non-infertility diagnoses. This study was performed using cryopreserved (frozen) chromosomally tested normal embryos that were placed back into the uterus during a frozen embryo cycle.

Do Women With Endometriosis Produce Normal Embryos?

In addition to the questions of the receptivity of the uterus for embryos, there are many questions about the health of the eggs and embryos from women with endometriosis. This discussion in the literature focuses on whether eggs from women with endometriosis have a lower chance of yielding healthy embryos with normal chromosomes. Women with endometriosis have increased inflammation and elevated free radicals near the ovaries which could damage the eggs.

A recent study published in the February 2021 journal Fertility and Sterility helped answer a number of these questions related to the health of the eggs and embryos from women with endometriosis. 328 women, 52 with endometriosis 224 with male factor infertility and 50 otherwise healthy woman with an unrelated genetic reason to undergo IVF were studied. 1873 embryos from these women underwent PGT-A to determine if they were chromosomally normal (Euploid) or not (Aneuploid). The average age of the women was 35 and average BMI was 25 (normal BMI).

The results of the study showed that the number of mature eggs, the number of eggs that fertilized and the number of fertilized eggs that continued to grow for 5 days to blastocysts was the same in all groups.

In addition, and most importantly, the percentage of chromosomally abnormal embryos in women with endometriosis (45%) was the same as in the women with male factor infertility (42%); not unexpectedly, the percentage of chromosomally abnormal embryos in the fertile women (31%) was lower than the other 2 groups. These women required genetic testing as they were carriers for a single gene defect.

Endometriosis and IVF Success

This was a very encouraging study that showed that the eggs from women with endometriosis were no different than eggs from women with other infertility diagnoses. Women with endometriosis do not seem to have a lower chance of developing healthy, chromosomally normal (euploid) embryos than other infertile women. This another very reassuring finding for women with endometriosis and infertility.

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