UOG Journal Club: Impact of endometriosis and its staging on assisted reproduction outcome:...
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Impact of endometriosis and its staging on assisted reproduction outcome: systematic review and meta-analysis M.A.P. Barbosa, D. M. Teixeira, P.A.A.S. Navarro, R.A. Ferriani, C. O. Nastri, W. P. Martins Volume 44, Issue 3, Date: September 2014, Pages 261-278 Journal Club slides prepared by Ligita Jokubkiene (UOG Editor for Trainees) UOG Journal Club: September 2014
UOG Journal Club: Impact of endometriosis and its staging on assisted reproduction outcome: systematic review and meta-analysis
Impact of endometriosis and its staging on assisted reproduction outcome: systematic review and meta-analysis M.A.P. Barbosa, D. M. Teixeira, P.A.A.S. Navarro, R.A. Ferriani, C. O. Nastri, W. P. Martins Volume 44, Issue 3, Date: September 2014, Pages 261-278 http://onlinelibrary.wiley.com/doi/10.1002/uog.13366/abstract
Citation preview
1. UOG Journal Club: September 2014 Impact of endometriosis and
its staging on assisted reproduction outcome: systematic review and
meta-analysis M.A.P. Barbosa, D. M. Teixeira, P.A.A.S. Navarro,
R.A. Ferriani, C. O. Nastri, W. P. Martins Volume 44, Issue 3,
Date: September 2014, Pages 261-278 Journal Club slides prepared by
Ligita Jokubkiene (UOG Editor for Trainees)
2. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Does presence of endometriosis affect the outcome
of assisted reproductive techniques (ART)? Does severity of
endometriosis affect the outcome of ART? Endometriosis affects:
6-10% of women of fertile age 35-50% women with subfertility,
pelvic pain or both Endometriosis treatment: Impact of
medical/surgical treatment on fertility is controversial
3. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Aim To evaluate whether the presence or severity
of endometriosis affects the reproductive outcomes of women
undergoing assisted reproductive techniques
4. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Inclusion criteria Any study with data on ART
outcomes* in women undergoing ART with and without a previous
diagnosis of endometriosis Studies comparing ART outcomes with
different stages of endometriosis *Live birth, clinical pregnancy,
miscarriage, number of oocytes retreived
5. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Data extracted from studies Study characteristics
(design, aims, time period, inclusion and exclusion criteria)
Intervention and setting Ovulation induction protocol Severity of
endometriosis Endometriosis treatment before ART
6. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Main outcomes Primary outcome: Live birth
Secondary outcome: Clinical pregnancy Additional outcomes:
Miscarriage Number of oocytes retreived Quality of evidence of
studies analyzed by Newcastle-Ottawa scale
http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
7. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Effect of
disease 20167 with endometriosis compared with 121931 women without
endometriosis Barbosa et al., UOG 2014 Effect of severity 1703
women with Stage III/IV compared with 2227 women with Stage I/II
endometriosis
8. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Results: endometriosis vs control Higher
miscarriage risk for women with endometriosis Lower number of
retrieved oocytes in women with endometriosis
9. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Results: Stage I/II vs Stage III/IV risk
comparison Lower number of retreived oocytes in women with Stage
III/IV endometriosis vs Stage I/II
10. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Conclusions Women undergoing ART have the same
chance of achieving clinical pregnancy and live birth irrespective
of the absence/presence or severity of endometriosis
11. Impact of endometriosis and its staging on assisted
reproduction outcome: systematic review and meta-analysis Barbosa
et al., UOG 2014 Conclusions Fewer oocytes are retrieved from women
with endometriosis vs no endometriosis Fewer oocytes are retrieved
from women with Stage III/IV endometriosis vs Stage I/II Possible
higher risk for miscarriage in women with endometriosis
12. Discussion points Should endometriosis be treated prior to
commencing ART treatment in order to improve pregnancy rate? Do
women with endometriosis have lower chance of live birth compared
to women with other causes of infertility? Do women with advanced
stage endometriosis have lower chances of live birth? What are the
mechanisms that affect the chances of achieving a live birth in
women with endometriosis? What adverse ART outcomes are more likely
in women with endometriosis?