Effect of endometriosis activity on pregnancy outcome in patients with repeated implantation failure

Patients face a problem in IVF/ICSI treatment,repeated planting failure.In order to explore whether endometriosis affects the implantation of embryo when IVF/ICSI,this study compared the pregnancy outcomes of patients with endometriosis who failed to implant repeatedly.So as to explore the appropriate treatment plan for such patients. Endometriosis patients with repeated implantation failure were grouped according to the timing of treatment and whether down-regulated or not. patients who asked for IVF/ICSI treatments in our Reproductive Center.A retrospective cohort study was performed on endometriosis patients with repeated implantation failure.The differences in pregnancy outcomes were compared.The comparison between quantitative data was tested by analysis of variance.The differences between the classification data were analyzed by chi-square test. 1) According to treatment timings, the cumulative delivery rate(according to the numbers of people)was significantly lower than that of the early treatment group (28.17% vs 43.30%, P<0.05) and the late treatment group (28.17% vs 47.06%, P<0.01). The available embryo rate(93.56%) and high quality embryo rate (81.84%) in the early treatment group were significantly higher than those in the untreated group (85.20% and 62.93%) and the late treatment group(88.20% and 69.61%), P<0.01. And the high quality embryo rate in the late treatment group(69.61%) was also significantly higher than that in the untreated group(62.93%), P<0.05. 2) Kplan-Meier curve analysis showed that the time required to get a pregnancy(live birth) for late treatment group was the shortest (12.21±1.05, 13.46±1.08), and the time in the untreated group was longest(21.54±0.49, 22.27±0.45), P<0.001. 3)Down-regulation increased the clinical pregnancy rate of the untreated group and the late treatment group (41.18% vs 26.32% vs 50.00% vs 24.62%, P<0.05), and the live birth rate of the treatment group(38.78% vs 17.97% and 41.67% vs 17.69%, P <0.01). Down-regulation can increase the overall cumulative live birth rate (cycle) (27.78% vs 13.51%, 45.24% vs 12.99% and 46.30% vs 13.69%, P<0.05).multivariate logistic regression analysis adjusted the basic line, the live birth rate of the down-regulated group was 2.249 times higher than that of the non-down-regulated group (P<0.05). 4) According to the EMs activity, the clinical pregnancy rate(38.84%) and live birth rate(29.75%) of the EMs-controlled patients were increased compared to the uncontrol group (26.25% and 18.13%, P <0.05). 1) The treatment of endometriosis will improve the cumulative pregnancy rate and live birth rate of repeated implantation failure; 2) The down-regulation cycle can also improve the pregnancy outcome of endometriosis patients with repeated implantation failure; 3) The control of endometriosis activity can lead to better clinical outcomes in patients with repeated implant failures; 4) It is necessary to control the activity of endometriosis in patients with repeated implantation failures in IVF/ICSI treatment.