Improving the probability of pregnancy in endometriosis cases: a study in patients undergoing in vitro fertilization

  • Taufik Jamaan
  • Arief Boediono
  • Trevino A. Pakasi
  • Farid A. Moeloek
Keywords: Embryo transfer, endometriosis, oocyte and embryo quality, pregnancy rate
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Abstract

Background: Endometriosis is the most common condition underlying infertility in women. To increase the rate of pregnancy in women with endometriosis, embryo selection is performed during in vitro fertilization. This study aims to prove the effectiveness of embryo selection on the rate of pregnancy in a hospital in Jakarta.

Methods: This is a cross sectional clinical epidemiology study, performed on endometriosis patients who visited the hospital between 2007-2009. Patients were diagnosed with endometriosis using the laparoscopy technique. Embryo selection was performed by assessing the morphology and cell count.

Results: We were able to collect data from 72 subjects who underwent IVF during this research period. One subject was dropped out of the program due to immaturity of the oocyte. Successful fertilization was achieved for 65 subjects, but two of them did not undergo embryo transfer. Out of all the subjects undergoing embryo transfer, 26 subjects successfully became pregnant (36.1%). In severe endometriosis cases, pregnancy was achieved with excellent quality embryos (50%) and good-moderate quality embryos (16.7%); but the probability of failure to become pregnant was found to be the same (50%). In mild-moderate endometriosis cases, the probability of pregnancy with excellent quality embryos was 39% compared to 25% chance with good-moderate quality embryos. Regarding the number of embryos that were transferred, we have found that the probability of pregnancy was 50% higher when 3 embryos were transferred, compared to 1 or 2 transferred embryos.

Conclusion: This study shows that embryo quality and the number of transferred embryos are relevant to increase the probability of pregnancy in patients undergoing IVF. But because the probability of not achieving pregnancy is not significantly different, we need to find another marker that is more sensitive to assess the quality of embryo transfer. (Med J Indones. 2012;21:147-51)

References

  1. Desai N, Filipovits J, Goldfarb J. Secretion of soluble HLA-G by day 3 human embryos associated with higher pregnancy and implantation rates: assay of culture media using a new ELISA Kit. Reprod Biomed Online. 2006;13(2):272-7.

  2. Jamaan T, Anwar IN. Manual inseminasi intra uterus (IIU). Klinik Fertilitas Morula, Rumah Sakit Bunda Jakarta: Puspa Swara; Mei 2002, Vol. 1. Indonesian.

  3. Yie SM, Balakier H, Motamedi G, Librach CL. Secretion of human leukocyte antigen-G by human embryos is associated with a higher in vitro fertilization pregnancy rate. Fertil Steril. 2005;83:30-6.

  4. Szmigiel OS, Walknowska ER, Cybulski C, Plonka T, Lubinski J. Antigens HLA-G, sHLA-G and sHLA – class I in reproductive failure. Folia Histochem Cytobiol. 2007;45:137-41.

  5. Bulleti C, Flamigni C, de Ziegler D. Implantation markers and endometriosis. Reprod Biomed Online. 2005;11(4):464-8.

  6. Lutan D, Halim B, Adenin I. Endometriosis dan teknologi bantuan reproduksi. FIV dalam praktek klinik. Ed 1. Jun 2006. p. 107-11. Indonesian.

  7. Warner CM, Comiskey M, Clisham PR, Brenner CA. Soluble HLA-G (sHLA-G) a predictor of IVF outcome? J Assist Reprod Genet. 2004;21:315-6.

  8. Noci I, Fuzzi B, Rizzo R, Melchiorri L, Criscuoli L, Dabizzi S, et al. Embryonic soluble HLA-G as a marker of developmental potential in embryos. Hum Reprod. 2005;20:138-46.

  9. Van Lierop MJ, Wijnands F, Loke YW, Emmer PM, Lukassen HG, Braat DD, et al. Detection of HLA–G by a specific sandwich ELISA using monoclonal antibodies G233 and 56B. Mol Hum Reprod. 2002;8:776-84.

  10. Jamaan T, Darmasetiawan MS, Anwar INC, Djuwantono T, Adenin I. Fertilisasi in vitro dalam praktek klinik (manual bayi tabung). Puspa Swara: Juni 2006, Vol. 1. Indonesian.

  11. Olivennes F, Feldberg D, Liu HC, Cohen J, Moy F, Rosenwaks Z. Endometriosis: a stage by stage analysis – the role of in vitro fertilization. Fertil Steril. 1995;64:392-8.

Published
2012-08-01
How to Cite
1.
Jamaan T, Boediono A, Pakasi TA, Moeloek FA. Improving the probability of pregnancy in endometriosis cases: a study in patients undergoing in vitro fertilization. Med J Indones [Internet]. 2012Aug.1 [cited 2023Jan.31];21(3):147-51. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/497
Section
Clinical Research