IVF outcome in women with accidental contamination of follicular fluid with endometrioma content.

Objective: To evaluate whether accidental contamination of follicular fluid with endometrioma content during oocytes retrieval affects IVF outcome.

Study Design: We set up a retrospective review of women undergoing IVF in our infertility unit during a four years period. Cases were 19 women with ovarian endometriomas who had an accidental aspiration of the endometrioma content during oocyte retrieval. Controls (n=38) were the two subsequent age-matched women with endometriomas who underwent an uncomplicated oocyte retrieval. The main outcome was to evaluate the clinical pregnancy rate in cases and in controls.

Results: Accidental aspiration of endometrioma content occurred in 19 out of 314 women (6.1%, 95%CI: 3.8-9.1%). The number of embryos and top quality embryos was significantly higher in exposed women (3.1±2.0 versus 1.7±1.2 and 1.9±1.5 versus 1.1±1.1, respectively) but the chances of pregnancy were lower. The adjusted RRs of clinical pregnancy and live birth were 0.63 (95%CI: 0.49-0.87, p=0.005) and 0.60 (95%CI: 0.51-086, p=0.003), respectively.

Conclusion: Accidental contamination of the follicular fluid with endometrioma content is an uncommon but possible event. This situation may affect IVF outcome but does not justify systematic surgical removal before the cycle.