OBJECTIVE To describe the outcome of fertility preservation (FP) using vitrified oocytes in patients with endometriosis and to determine the impact of ovarian surgery. DESIGN Retrospective observational study. SETTING University-affiliated private in vitro fertilization (IVF) center. PATIENT(S) Four hundred and eighty-five women with endometriosis who underwent FP from January 2007 to July 2018. INTERVENTION(S) Vitrification of metaphase II (MII) oocytes for future use. MAIN OUTCOME MEASURE(S) Oocyte survival rate and cumulative live-birth rate (CLBR). RESULT(S) Mean age at vitrification was 35.7 ± 3.7 years. The women undergoing operations were younger than the nonsurgical patients (33.4 ± 3.6 years vs. 36.7 ± 3.7 years). The survival rate and CLBR were 83.2% and 46.4%, respectively. The number of vitrified oocytes per cycle (6.2 ± 5.8) was higher for the nonsurgical patients compared with the unilateral (5.0 ± 4.5) or bilateral (4.5 ± 4.4) surgery groups, but was comparable among the surgical patients. The effect of age (adjusted odds ratio [OR] 0.904; 95% CI, 0.858-0.952), number of oocytes (adjusted OR 1.050; 95% CI, 1.025-1.091), and survival (adjusted OR 1.011; 95% CI, 1.001-1.020) on the CLBR was confirmed. However, the effect of surgery was not observed (adjusted OR 1.142; 95% CI, 0.778-1.677). Nonetheless, the ovarian response (vitrified oocytes = 8.6 ± 6.9 vs. 5.1 ± 4.8) and CLBR (72.5% vs. 52.8%) were higher in young (≤35 years) nonsurgical patient versus the surgical patients; older women showed similar outcomes. CONCLUSION(S) Fertility preservation gives patients with endometriosis a valid treatment option to help them increase their reproductive chances. We suggest performing surgery after ovarian stimulation for FP in young women. In older women, an individualized treatment should be considered.

中文翻译：

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卵母细胞玻璃化冷冻保存子宫内膜异位症妇女的生育能力：一项观察性研究

目的 描述子宫内膜异位症患者使用玻璃化卵母细胞保留生育能力 (FP) 的结果，并确定卵巢手术的影响。设计 回顾性观察研究。设置 大学附属的私人体外受精 (IVF) 中心。患者 2007 年 1 月至 2018 年 7 月期间接受 FP 的 485 名子宫内膜异位症女性。 干预措施 中期 II (MII) 卵母细胞玻璃化冷冻以备将来使用。主要结局指标 卵母细胞存活率和累积活产率 (CLBR)。结果玻璃化冷冻的平均年龄为 35.7 ± 3.7 岁。接受手术的女性比非手术患者年轻（33.4 ± 3.6 岁 vs. 36.7 ± 3.7 岁）。存活率和 CLBR 分别为 83.2% 和 46.4%。每个周期的玻璃化卵母细胞数 (6.2 ± 5. 8) 与单侧 (5.0 ± 4.5) 或双侧 (4.5 ± 4.4) 手术组相比，非手术患者更高，但在手术患者中具有可比性。年龄的影响（调整后的比值比 [OR] 0.904；95% CI，0.858-0.952）、卵母细胞数量（调整后的 OR 1.050；95% CI，1.025-1.091）和存活率（调整后的 OR 1.011；95% CI） 1.001-1.020) 在 CLBR 上得到确认。然而，没有观察到手术的效果（调整后的 OR 1.142；95% CI，0.778-1.677）。尽管如此，年轻（≤35 岁）非手术患者的卵巢反应（玻璃化卵母细胞 = 8.6 ± 6.9 比 5.1 ± 4.8）和 CLBR（72.5% 比 52.8%）高于手术患者；老年妇女表现出类似的结果。结论（S）生育力保留为子宫内膜异位症患者提供了有效的治疗选择，以帮助他们增加生育机会。我们建议年轻女性在卵巢刺激后进行手术治疗 FP。对于老年女性，应考虑个体化治疗。