Luaran Transfer Embrio Simpan Beku pada Pasien Endometriosis Pasca Operasi dan Non Endometriosis yang Menjalani IVF di Klinik Permata Hati RSUP Dr. Sardjito
Rina Fatmawati(1*), Shofwal Widad(2), Agung Dewanto(3)
(1) Departemen Obstetri dan Ginekologi, FK-KMK, UGM
(2) Departemen Obstetri dan Ginekologi, FK-KMK, UGM
(3) Departemen Obstetri dan Ginekologi, FK-KMK, UGM
(*) Corresponding Author
Abstract
Background: Endometriosis is a chronic condition that is influenced by the hormone estrogen which affects women of childbearing age, and is associated with pelvic pain and infertility. In Vitro Fertilization (IVF) is currently the most efficient assisted reproductive technology and its high success rate is often done for infertility therapy in women associated with endometriosis
Objective: The aim of this study is to determine whether postoperative endometriosis affected pregnancy outcomes in patients underwent frozen embryo transfer in IVF / ICSI programs.
Method: This Research is done with a retrospective cohort design. The data was taken from medical records, research subjects who met the inclusion and exclusion criteria. The research data was collected, processed and analyzed using SPSS 23. Univariate, bivariate and multivariate data analysis was carried out to determine the effect between variables
Result: There were 458 research subjects in this study. Endometriosis patients were 119 subjects (26%). 57 subjects were categorized as minimum-mild endometriosis (47.9%) and moderate-severe subjects as many as 62 subjects (52.1%). The biochemical pregnancy rate (36.31%) and clinical pregnancy (29.4%) in patients with endometriosis was slightly higher than in non-endometriosis. But statistically it did not affect success rate of achieving biochemical (p = 0.428; RR 0.89; 95% CI: 0.71-1.24) and clinical pregnancy (p = 0.535; RR 0.883; 95% CI: 0.63- 1.22). The rate of miscarriage in postoperative endometriosis patients was higher than non-endometriosis patients (88.6% vs 80.7%) but was not statistically significant (p = 0.294; RR 1.69; 95% CI: 0.61-4.67) . Biochemical and clinical pregnancies were significantly affected by age, infertility, endometrial thickness, embryo age and embryo quality. The incidence of miscarriage was affected by the ovarian stimulation protocol.
Conclusion: Endometriosis post operative statistically has no effect on pregnancy outcomes in the IVF / ICSI cycle with frozen embryo transfer compared with another cause of infertility .
Keywords:
Endometriosis, In Vitro Fertilization, Clinical pregnancy, biochemical pregnancy, miscarriage
Keywords
Full Text:
PDFReferences
Benaglia L, Candotti G, Papaleo E, Pagliardini L, Leonari M, Reschini M,Quaranta L,Munaretto M, Viganò P, Candiani M, Vercellini P, and Somigliana E. 2016. Pregnancy Outcome in Women with Endometriosis Achieving Pregnancy with IVF. Hum. Reprod , 31(12), pp.2730–2736.
Garrido Nicolas, Navaro J, Remohi J, Simon C and Pallicer A. 2000. Follicullar Hormonal Environment and Embryo Quality in Women with Endometriosis. Human. Reproduction. Update., 6, 67-74.
Jacobson TZ, Duffy JM, Barlow D, Farquhar C, Konninckx PR, Olive D. 2010. Laparoscopic Surgery n for Subfertility Assosiated with Endometriosis. Cochrane Database Syst review; (1);CD001398.
Alkudmani B, Buell D, Salman J, Librach C, Sharma P. A. 2004. In Vitro Fertilization (IVF) Success Rates in Patients with Surgically Diagnosed Endometriosis and Effect of Time Interval from Surgery to IVF Cycle. fertstert.org/article/S0015-0282(14)01684-7.
Kuivasaari Paula, Hippeläinen Maritta, Anttila Maarit and Heinone Seppo. 2005. Effect of Endometriosis on IVF/ICSI Outcome: Stage III/IV Endometriosis Worsens Cumulative Pregnancy and Live-Born Rates. Human Reproduction Vol.20, No.11 pp. 3130–3135.
Brizek, C.L., Schalaff, S., Pellegrini, V.A., Frank, J.B. and Worrilow, K.C. 1995. Increased Incidence ff Aberrant Morphological Phenotypes in Human Embryogenesis – An Association with Endometriosis. J. Assist. Reprod . Genet., 12, 106-112.
Surrey ES. 2014. Endometriosis-Related Infertility: The Role of the Assisted Reproductive Technologies. Hindawi Publishing Corporation. BioMed Research International Volume 2015, Article ID 482959, 8 pages
Barnhart, K., Dunsmoor-su, R. & Coutifaris, C., 2002. Effect of Endometriosis on in Vitro Fertilization. Fertility and Sterility, 77(6).
Evans J, Hannan NJ, Edgell TA, et al. 2014. Fresh versus frozen embryo transfer: backing clinical decisions with scientific and clinical evidence. Hum Reprod 2014;20:808–21.
Salumets Andres, Suikari Anne Maria, Makinem Sirpa, Karro Helle, Roos Anu and Tuuri Timmo. 2006. Frozen Embryo Transfer: Implication of Clinical and Embriological Factors on the Pregnancy Outcome. Hum. Rep. (21). 2368-2374
Sharkey AM, Smith SK. 2003. The endometrium as a cause of implantation failure. Best Pract Res Clin Obstet Gynaecol;17:289 –307.
Queiroz Vaz G, Evangelista AV, Almeida Cardoso MC, Gallo P, Erthal MC, Pinho Oliveira MA. 2017. Frozen embryo transfer cycles in women with deep endometriosis. Gynecol Endocrinol. Jul;33(7):540-543.
Ahmed M.F.Mohammed, Spyridon Chouliaras, Carolyn J.P. Jones, Luciano G, Nardo. 2011. Live Birth Rate in Frozen Embryo Transfer Cycles in Women with Endometriosis. European Journal of Obsterics and Ginecology and Reproductive Biology; 10.1016/j.ejorgb.2011.01.020
Pellicer A, Oliveira N, Ruiz A, Remohi Jose and Simon C. 1995. Exploring the Mechanism(s) of Endometriosis-Related Infertility: An Annalysis of Embryo Development and Implantation in Assisted Reproduction. Human. Reproduction.Vol 10. Supplement 2.
Garrido N, Navarro J, García-Velasco J, Remoh J, Pellice A, Simón C. 2002. The endometrium versus embryonic quality in endometriosis-related infertility. Hum Reprod Update.;8:95–103.
Cazalis CG, Koskas Martin, Scali Sandrine Cohen, Luton Dominique, Yazbeck Chadi. 2012. Endometriosis and implantation: Myths and facts. Middle East Fertility Society Journal. Vol 17, 79–81
Mostaejeran Fatemeh, Hamoush Zeinab, and Rouholamin Safoura. 2015. Evaluation of antimullerian hormone levels before and after laparoscopic management of endometriosis. Adv Biomed Res; 4: 182.
Hock DL , Sharafi K, Dagostino L, Kemmann E, Seifer DB. 2001. Contribution of diminished ovarian reserve to hypofertility associated with endometriosis. J Reprod Med. Jan;46(1):7-10.
Barri PN, Coroleu B, Tur R, Barri-Soldevila PN, Rodríguez I. 2010. Endometriosis-associated infertility surgery and IVF a comprehensive therapeutic approach. Reprod Biomed Online.21:179–185. doi: 10.1016/j.rbmo.2010.04.026.
Barbosa MA, Teixeira DM, Navarro PA, et al. 2014. Impact of endometriosis and its staging on assisted reproduction outcome: systematic review and meta-analysis. Ultrasound Obstet Gynecol;44: 261–78.
Opoien HK, Fedorcsak P, Omland AK, Abyholm T, Bjercke S, Ertzeid G, Oldereid N, Mellembakken JR, Tanbo T. 2012. In vitro fertilization is a successful treatment in endometriosis-associated infertility. Fertil Steril. Apr 2012; 97(4):912-8.
Arici A, Oral E, Bukulmez O, Duleba A, Olive DL, Jones EE. 1996. The effect of endometriosis on implantation: results from the Yale University in vitro fertilization and embryo transfer programme. Fertil Steril. 65(3):603–7.
Saito H, Seino T, Kaneko T, Nakahara K, Toya M, Kurachi H. Endometriosis and oocyte quality. Gynecol Obstet Invest. 2002;53(Suppl 1):46–51
Hickman TN. 2002. Impact of endometriosis on implantation. Data from the Wilford Hall Medical Center IVF-ET Program. J Reprod Med; 47(10):801–8.
Coccia ME, Rizello F, Mariani G, Bulletti C, Palagiano A, Scarselli G. 2011. Impact of endometriosis on in vitro fertilization and embryo transfer cycles in young women: a stage-dependent interference. Acta Obstet Gynecol Scand;90(11):1232–8.
Bukulmez O, Yarali H, Gurgan T. 2001. The presence and extent of endometriosis do not effect clinical pregnancy and implantation rates in patients undergoing intracytoplasmic sperm injection. Eur J Obstet Gynecol Reprod Biol 2001;96(1):102–7
Leonardi M, M.D., Papaleo E, M.D., Reschini M, M.Sc., Pagliardini L, M.D., Benaglia L, M.D. et al. 2016. Risk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles. Fertil Steril 106(2):386-392.e3.
Azra Azmoudeh, Zahra Shahraki ID, Fatemeh-Sadat Hoseini, Firoozeh Akbari-Asbagh1, Fatemeh Davari-Tanha, Forough Mortazavi. 2018. In Vitro Fertilization Success and Associated Factors: A Prospective Cohort Study International Journal of Women’s Health and Reproduction Sciences Vol. 6, No. 3, 350–355
Templeton Allan, Morris Joan K, Parslow William. 1996. Factors that Affect Outcome of in-Vitro Fertilisation Treatment. Lancet;348:1402–06.
El-Toukhy T, Coomarasamy A, Khairy M, Sunkara K, Seed P, Khalaf Y, et al. 2008. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertil Steril;89: 832e9
Kathiresan A, E. T. Wang, N. Greene, C. J. Alexander, M. D. Pisarska. 2015. Abnormal implantation in day 3 versus day 5 embryo transfers in fresh ivf cycles: an analysis from the society for assisted reproductive technology database. Fertil Steril Volume 104, Issue 3, Supplement, Page e99
Oehninger S. 2001. Ovulation induction in IVF. Minerva Ginecol. Apr;63(2):137-56.
Mahnaz Ashrafi, Nadia Jahangiri, Fatemeh Hassani, Mohammad Reza Akhoond, Tahereh Madani. 2009. The factors affecting the outcome of frozenethawed embryo transfer cycle. Taiwanese Journal of Obstetrics & Gynecology 50 (2011) 159-164.
DOI: https://doi.org/10.22146/jkr.56940
Article Metrics
Abstract views : 2626 | views : 5500Refbacks
- There are currently no refbacks.
Copyright (c) 2020 The Author(s)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
SEKRETARIAT JURNAL KESEHATAN REPRODUKSI
Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito
Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281
Tlp: (0274) 511329 / Faks: (0274) 544003
Email: jurnal.kesehatanreproduksi@ugm.ac.id
Cp: Dwi Astuti +6281802698043