Reproductive outcomes following fertility preservation in women with endometriosis

IF 3.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2026-02-01 Epub Date: 2025-09-05 DOI:10.1016/j.rbmo.2025.105242

Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo

{"title":"Reproductive outcomes following fertility preservation in women with endometriosis","authors":"Rebecca Goldstein , Alexandra Benoit , Michaël Grynberg , Louise Vrtovsnik , Sophia Rakrouki , Céleste Becquart , Ines Sellami , Claire Vinolas , Vincent Puy , Florence Eustache , Anne Mayeur , Maeliss Peigné , Charlotte Sonigo","doi":"10.1016/j.rbmo.2025.105242","DOIUrl":null,"url":null,"abstract":"<div><h3>Research question</h3><div>What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.</div></div><div><h3>Design</h3><div>This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.</div></div><div><h3>Results</h3><div>Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, <em>P</em> < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.</div></div><div><h3>Conclusions</h3><div>Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.</div></div>","PeriodicalId":21134,"journal":{"name":"Reproductive biomedicine online","volume":"52 2","pages":"Article 105242"},"PeriodicalIF":3.9000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive biomedicine online","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472648325004493","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Research question

What are the fertility outcomes in women with endometriosis who attempt to conceive at least 2 years after undergoing fertility preservation.

Design

This retrospective, observational, bicentric cohort study included women diagnosed with endometriosis confirmed by imaging (pelvic magnetic resonance imaging or ultrasonography) who underwent at least one controlled ovarian stimulation cycle for fertility preservation between 1 July 2013 and 31 December 2019.

Results

Among 200 participants, follow-up data were available for 184, of whom 76 (41.3%) had attempted to conceive by the end-point (15 February 2023). The median number of oocytes and/or embryos vitrified per patient was 14 (interquartile range [IQR] 8–20). Being in a relationship at the initial consultation was significantly associated with later conception attempts (70.7% versus 25.7%, P < 0.0001). Overall, 48 (63.2%) achieved a pregnancy: 50% naturally, 37.5% using frozen material, and 12.5% via a new IVF attempt with fresh oocytes. Live birth occurred in 31 (40.8%). Among those who had attempted conception, the 4-year cumulative pregnancy incidence following fertility preservation was estimated at 55% (95% CI 45–68%). The cryopreserved material utilization rate was estimated at 48% (95% CI 37–63%) 5 years after fertility preservation. Nulliparity (hazard ratio [HR] 1.43, 95% CI [1.00–2.06] ) and having frozen embryos (HR 2.34, 95% CI [1.65–3.33]) were significant predictors of material use over the follow-up period.

Conclusions

Despite the known detrimental effects of endometriosis on fertility, a majority of women who attempted to conceive following fertility preservation achieved pregnancy, with a substantial proportion conceiving naturally. Half of these used their cryopreserved material, supporting fertility preservation as part of comprehensive reproductive counselling in endometriosis care.

查看原文本刊更多论文

子宫内膜异位症患者保留生育能力后的生殖结果

研究问题子宫内膜异位症患者在接受保存生育能力至少2年后尝试怀孕的生育结果是什么？这项回顾性、观察性、双中心队列研究纳入了2013年7月1日至2019年12月31日期间接受至少一个控制卵巢刺激周期以保持生育能力的经影像学（盆腔磁共振成像或超声检查）确诊为子宫内膜异位症的女性。结果在200名参与者中，有184人获得随访数据，其中76人（41.3%）在终点（2023年2月15日）尝试怀孕。每位患者玻璃化卵母细胞和/或胚胎的中位数为14个（四分位数范围[IQR] 8-20）。在初次咨询时处于恋爱关系中与后来的受孕尝试显著相关（70.7%对25.7%,P < 0.0001）。总体而言，48例（63.2%）成功怀孕：50%自然受孕，37.5%使用冷冻材料，12.5%通过新鲜卵母细胞进行新的IVF尝试。活产31例（40.8%）。在尝试受孕的患者中，保留生育能力后的4年累计妊娠发生率估计为55% （95% CI 45-68%）。冷冻保存后5年的材料利用率估计为48% （95% CI 37-63%）。未生育（风险比[HR] 1.43, 95% CI[1.00-2.06]）和冷冻胚胎（风险比[HR] 2.34, 95% CI[1.65-3.33]）是随访期间材料使用的重要预测因素。结论：尽管已知子宫内膜异位症对生育能力有不利影响，但大多数尝试保留生育能力的妇女都成功怀孕，其中很大一部分是自然受孕。其中一半使用了冷冻保存的材料，支持将生育能力保存作为子宫内膜异位症护理中全面生殖咨询的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.