Browsing by Author "Pfeiffer, Nadine"

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    A retrospective study of the effect of endometriosis on reproductive outcomes in assisted reproductive treatment
    (Stellenbosch : Stellenbosch University, 2023-03) Pfeiffer, Nadine; Erasmus, Evelyn; Burger, Riana; Matsaseng, T.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.
    ENGLISH SUMMARY: Background: One of the leading causes of female infertility is a chronic condition known as endometriosis. There are four stages of endometriosis, and 25 to 50% of affected women experience endometriosis-related infertility. Endometriosis is suggested to impair the pelvic environment, ovaries (oocyte quality and quantity), and the uterus. Endometriosis is a frequent indicator for Assisted Reproductive Treatment (ART). However, there is a lack of consensus regarding the impact of this disease and its subsequent stages on outcomes achieved in ART. With the optimisation of ART, it is necessary to further evaluate the effect endometriosis may have on reproductive and embryological outcomes. Objectives: Primary objective: To retrospectively evaluate the reproductive outcomes (post-embryo transfer) of endometriosis patients (EE group) compared to the success of tubal factor infertility patients (TF group) by calculating implantation rate (IR), clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate (MR). Secondary objective: To retrospectively evaluate the pre-embryo transfer outcomes of the EE group and TF group by calculating fertilisation rate (FR), number of oocytes retrieved, percentage of good quality day 3 embryos (GQE), and blastulation rate (BR). Tertiary objective: To retrospectively evaluate whether the stage of endometriosis affects BR, IR, CPR, LBR, and MR. Materials and Methods: This retrospective study (2017 to 2020) used anonymised data from the Tygerberg and Aevitas Fertility Clinics. It included a study group, the EE group (N = 101) and a control group, the TF group (N = 110). The EE group were subdivided, if the stage of endometriosis (ES) was known, as stage I and II (ES1-2 group [n=13]) and stage III and IV (ES3-4 group [n=65]). The data was submitted for statistical analysis, with statistical significance defined as P < 0.05. Results: Compared to the TF group, the EE group had a higher, but non-significant (p>0.05) number of metaphase II (MII) oocytes retrieved (6.02 MII oocytes vs 5.6 MII oocytes), IR (23.27% vs 19.6%), CPR (32.67% vs 32.11%), MR (28.13% vs 25.00%), and LBR (78.13% vs 75.00%). However, the EE group had a significantly reduced FR compared to the TF group (82.19% vs 87.46%, P = 0.04). Nonetheless, the GQE (77.66% vs 75.73%) and the BR (58.7% vs 63.79%) of the two groups were similar. No statistically significant differences (p>0.05) were found between the ES1-2 group and the ES3-4 group regarding BR (62.11% vs 57.63%), IR (26.92% vs 20.77%), CPR (38.46% vs 29.23%), and LBR (100% vs 66.67%). The MR of the ES3-4 group was significantly higher than the ES1-2 group (38.89% vs 0%, P = 0.04), however, the small sample size queries the validity. Conclusions: The current study found that endometriosis does not have a negative impact on post-embryo transfer reproductive outcomes, during ART. Similarly, the disease does not have a negative effect on the number of MII oocytes retrieved, GQE, and BR. However, a significantly reduced FR in the EE group was indicated, which may be a result of oocyte abnormalities in endometriosis patients. Furthermore, the study found that the reproductive outcomes and BR were lower in ES3-4 group, although it was not significant.