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Meta-Analysis Systematic Review Journal Article Research Support, Non-U.S. Gov't Epublish 25 citations

PubMed: 38294811 DOI: 10.1001/jamanetworkopen.2023.54249

Live Birth After Oocyte Donation In Vitro Fertilization Cycles in Women With Endometriosis: A Systematic Review and Meta-Analysis.

JAMA Netw Open 7(1):e2354249

Authors: Alessio Paffoni, Maíra Casalechi, Dominique De Ziegler, Ettore Cicinelli, Edgardo Somigliana, Paola Viganò, Amerigo Vitagliano

Affiliations

  • Infertility Unit, ASST Lariana, Cantù (Como), Italy.
  • Human Reproduction Unit of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
  • Department of Obstetrics, Gynecology and Human Reproduction, Hospital Foch, Suresnes, France.
  • First Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy.
  • Infertility Unit, Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Abstract

Importance

Although multiple mechanisms have been proposed to explain the infertility related to endometriosis, there are no conclusive data on the association of endometriosis with endometrial receptivity. The oocyte donation model in assisted reproduction technology (ART) cycles can clarify this issue.

Objective

To explore the association of a history of endometriosis with ART outcomes in recipients of oocyte donation.

Data Sources

In this systematic review and meta-analysis, electronic databases were searched from inception until August 31, 2023, using combinations of relevant keywords. Moreover, we retrieved data from the databases of the Society for Assisted Reproductive Technology (SART) in the US and the Human Fertilization and Embryology Authority (HFEA) in the United Kingdom.

Study Selection

Observational studies were included if they investigated the impact of endometriosis on ART outcomes with donor oocytes.

Data Extraction and Synthesis

Publicly available data related to ART from various sources were gathered, and a retrospective aggregate and nonaggregate analysis using registries of in vitro fertilization cycles with oocyte or embryo donation was conducted.

Main Outcomes and Measures

The primary outcome was live birth rate (LBR) following oocyte donor cycles. The effect measures of comparisons between groups are presented as odds ratios (ORs) with a 95% CI.

Results

This study analyzed 7212 oocyte donation cycles from 4 studies for the meta-analysis, along with 162 082 cycles from 2 registries (137 182 from SART and 24 900 from HFEA). No significant differences between the groups were observed in the meta-analysis of published data after adjusting for confounding factors (OR, 0.54; 95% CI, 0.19-1.57). A statistically significant lower LBR was identified in women with endometriosis when analyzing the aggregate data from SART and HFEA databases (OR, 0.89; 95% CI, 0.81-0.97).

Conclusions and Relevance

This study found a modest decrease in LBR among women with a history of endometriosis, although only results from the pooled analysis of registry data and not those from the meta-analysis reached statistical significance. These findings suggest that a marginal impairment of uterine receptivity may contribute to infertility mechanisms in women affected by endometriosis.

MeSH

Registries, Endometriosis, Oocyte Donation, Parturition, Infertility, Fertilization In Vitro, Oocytes, Clinical Medicine, History, Live Birth, Fertilization

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