Endometriosis and ovulatory disorder: reduced fertilisation in vitro compared with tubal and unexplained infertility.

In-vitro fertilisation (IVF) was carried out once for each of 104 couples who had a single cause of infertility. The group with tubal damage was used as the reference for normal fertilising capacity of both oocytes and sperms: the IVF rates were 68% (71/105) per mature oocyte and 88% (37/42) for couples from whom mature oocytes were recovered. Couples with poor sperm/mucus penetration had reduced IVF rates: 32% (12/38) per oocyte and 60% (9/15) per couple. Sperm function, which was judged normal by means of standard seminal analysis and mucus penetration, was confirmed by normal IVF in unexplained infertility: 63% (37/59) per oocyte and 90% (18/20) per couple. Despite favourable sperm function in their partners, women with endometriosis (without tubal damage) had reduced IVF rates: 33% (19/58) per oocyte and 60% (9/15) per couple. These findings indicate that ovulatory disorder is present in endometriosis and suggest that it causes the associated infertility.