Ovarian function in relation to the outcome of in vitro fertilization (IVF) treatment in regularly menstruating women with tubal infertility.

STUDY DESIGN

Ovarian endocrine function was evaluated in 53 regularly menstruating women, 27 to 38 years of age, who failed to conceive at least 2 years following reconstructive surgery for tubal infertility. Thirty apparently healthy women, 24 to 40 years of age with proven fertility, served as controls. Blood samples were obtained daily on cycle days 2-4 and 22-26 to assess FSH, E2, and P4 results.

RESULTS

There was a tendency for women with more advanced tubal damage to be subjected to more extensive surgery. Based on extent of reconstructive surgery, the patients were divided into three groups. Group A (n = 29) had less extensive surgery, limited to the fallopian tubes, group B (n = 14) included patients with extended adhesiolysis, and group C (n = 10) comprised patients that had the most extensive reconstructive procedures involving ovarian surgery. Significantly highest FSH levels were found in group C (P < 0.001) compared to groups A and B in the early follicular phase. During the luteal phase, E2 levels were lower in groups B (P < 0.01) and C (P < 0.001) compared to group A. P4 levels were lower in group C compared to groups A and B.

CONCLUSION

When the patients underwent IVF treatment higher grades of tubal damage, more extensive surgery and hormonal signs of ovarian insufficiency were highly related to treatment failure.