Contribution of diminished ovarian reserve to hypofertility associated with endometriosis

OBJECTIVE: To determine if ovarian reserve, as measured by day 3 levels of E-2 and FSH, was different in patients with endometriosis as compared to controls. STUDY DESIGN: Case-control study of 75 women with laparoscopically staged endometriosis and 75 age-matched controls undergoing in fertilization/embryo transfer for male factor infertility. RESULTS: In women with stage III/IV endometriosis (revised American Fertility Society staging), day 3 E-2 and FSH levels significantly higher than control levels (51.9 pg/mL and 12.6 mIU/mL versus 34.7 pg/mL and 9.7 mIU/mL, P < .03). In contrast, women with stage I/II endometriosis did not differ significantly when compared to controls (36.8 pg/mL and 10.4 mIU/mL versus 34.0 pg/mL and 10.2 mIU/mL). The total group showed significantly higher E-2 levels (41.8 pg/mL versus 34.1 pg/mL, P < .03), but no significantly differences in FSH levels were observed. CONCLUSION: These data show that women with III/IV endometriosis have relatively diminished ovarian reserve, while this situation is not noted in women with I/II endometriosis. This observation is consistent with progressive loss of ovarian reserve in women with increasing stages of endometriosis independent of age.