The Optimal Timing For In Vitro Fertilization After Surgical Removal Of Endometriomas

Objective:The purpose of this research is to investigate the optimal timing for IVF-ET after surgical removal of endometriomas and to evaluate the effect of the ultra-long down-regulation protocol.Methods:This retrospective research was in women’s hospital affiliated to Zhejiang University. Patients who underwent IVF-ET between January 2010 and December 2014 because of endometrioma-associated infertility were included.We analyzed the IVF outcome of the following groups:1) the time interval between the surgical removal of endometriomas and oocyte retrieval operation:less than 3months,4-6months,7-12months,13-24months and over 2 years; 2)ultra-long down-regulation protocol and regular down-regulation protocol.Result:Within 4-6 months after surgical removal of endometriomas, patients who underwent oocyte retrieval operation had higher embryo implantation rate, clinical pregnancy rate and live birth rate, but the differences were not significant statistically(p>0.05).When the time interval between the surgical removal of endometriomas and oocyte retrieval operation was less than 6 months, patients had significantly higher embryo implantation rate, clinical pregnancy rate and live birth rate(p<0.05).Patients in ultra-long down-regulation protocol group had significantly higher embryo implantation rate (38.64%) than patients in regular down-regulation protocol group(28.25%); clinical pregnancy rate and live birth rate were comparable between the two groups.When the time interval between the surgical removal of endometriomas and oocyte retrieval operation was over 2 years, ultra-long down-regulation protocol can improve the clinical pregnancy rate and live birth rate.Conclusion:For patients with endometrioma-associated infertility, FVF performed within 6 months after surgical removal of endometriomas is better than waiting for later.4-6 months after surgical removal of endometriomas may be recommended as the best treatment window for patients undergoing IVF procedure. When the time interval between the surgical removal of endometriomas and oocyte retrieval operation was over 2 years, ultra-long down-regulation protocol should be advised.