A retrospective study of the effect of endometriosis on reproductive outcomes in assisted reproductive treatment

Simple item page
dc.contributor.advisorErasmus, Evelynen_ZA
dc.contributor.advisorBurger, Rianaen_ZA
dc.contributor.advisorMatsaseng, T.en_ZA
dc.contributor.authorPfeiffer, Nadineen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.en_ZA
dc.date.accessioned2023-03-07T07:17:37Z
dc.date.accessioned2023-05-18T07:10:16Z
dc.date.available2023-03-07T07:17:37Z
dc.date.available2023-05-18T07:10:16Z
dc.date.issued2023-03
dc.descriptionThesis (MSc)--Stellenbosch University, 2023. en_ZA
dc.description.abstractENGLISH 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond: Een van die hoofoorsake van vroulike infertiliteit is ‘n chroniese toestand bekend as endometriose. Daar is vier stadiums van endometriose, en 25 tot 50% van geaffekteerde vroue het infertiliteitsprobleme. Endometriose kan die bekkenholte, eierstokke (oosiet kwaliteit en kwantiteit) en uterus benadeel. Endometriose is ‘n algemene indikasie vir Kunsmatige Reproduktiewe Behandeling (KRB). Daar is egter ‘n gebrek aan konsensus oor die impak en die stadiums van die siekte op reproduktiewe en embriologiese uitkomste tydens infertiliteitsbehandeling. Optimalisering van KRB maak dit nodig om die effek wat endometriose op reproduktiewe en embriologiese uitkomste het, verder te evalueer. Doelwitte: Primere doelwit: Om die reproduktiewe uitkomste - na embrioterugplasing [inplantingskoers (IK), kliniese swangerskapkoers (KSK), lewende geboortekoers (LGK), en miskraamkoers (MK)] van die endometriose (EE) groep teenoor die buisfaktor (TF) groep terugwerkend te evalueer. Sekondere doelwit: Om die pre-embrioterugplasing uitkomste – bevrugtingskoers (BVK), aantal oosiete wat herwin is, presentasie goeie kwaliteit dag 3 embrio’s (GKE) en blastoliseringskoers (BK) van die EE groep teenoor die TF groep terugwerkend te evalueer. Tersiere doelwit: Om terugwerkend te evalueer of die stadium van endometriose die reproduktiewe uitkomste (IK, KSK, LGK en MK) en BK affekteer. Materiale en Metodes: In hierdie terugwerkende studie (2017 tot 2020) is anonieme data van die Tygerberg en Aevitas Fertiliteitsklinieke gebruik. ‘n Studiegroep – EE groep [N=101] en ‘n kontrolegroep – TF groep [N=110] is vergelyk. Die EE groep is onderverdeel in twee subgroepe na aanleiding van die bekende stadium van endometriose (ES) - stadium I en II (ES1-2 group) en stadium III en IV (ES3-4 group). Die data is na versameling statisties ontleed en die statistiese beduidenheid is as as P < 0.05 aangedui. Resultate: Die EE groep, vergelykend met die TF groep, het ‘n hoer maar nie beduidende (P>0.05) aantal herwinne oosiete (6.02 MII oosiete vs 5.6 MII oosiete), IK (23.27% vs 19.6%.43), KSK (32.67% vs 32.11%), MK (28.13% vs 25.00%), en LGK (78.13% vs 75.00%0 getoon. Die EE-groep het egter ‘n betekenisvol laer BVK in vergelyking met die TF-groep (82.19% vs 87.46%, P = 0.04) getoon. Die twee groepe het ook soortgelyke GKE (77.66% vs 75.73%) en BK (58.7% vs 63.79%) getoon. Geen statistiese betekenisvolle verskille (P>0.05) is tussen die ES1-2 groep en die ES3-4 groep gevind ten opsigte van BK (62.11% vs 57.63%), IK (26.92% vs 20.77%), KSK (38.46% vs 29.23%), en LGK (100% vs 66.67%,) nie. Die MK van die ES3-4 groep was aansienlik hoer vergelykend met die ES1-2 groep (38.89% vs 0%) (P = 0.04), maar die klein steekproefgrootte in die twee groepe bevraagteken die geldigheid van die resultaat. Gevolgtrekking: Die huidige studie het bevind dat endometriose nie ’n negatiewe impak op post-terugplasing reproduktiewe uitkomste tydens KRB het nie. Die siektetoestand het ook nie ‘n negatiewe effek op die aantal MII-oosiete, GKE, en BK nie. ‘n Verlaagde bevrugtingskoers (BVK) is egter aangedui in die EE groep wat ‘n gevolg kan wees van abnormaliteite in die oosiete van endometriose pasiente. Die studie het ook bevind dat alhoewel die reproduktiewe uitkomste en BK laer is in die ES3-4 groep, dit nie statisties betekenisvol verskil nie.af_ZA
dc.description.versionMasters
dc.format.extentvii, 142 pages : illustrations, includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/127216
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subject.lcshArtificial insemination, Humanen_ZA
dc.subject.lcshInfertility, Femaleen_ZA
dc.subject.lcshHuman reproductive technologyen_ZA
dc.subject.nameUCTD
dc.titleA retrospective study of the effect of endometriosis on reproductive outcomes in assisted reproductive treatmenten_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
pfeiffer_retrospective_2023.pdf
Size:
5.98 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters Degrees (Obstetrics and Gynaecology)