Effects of reactive oxygen species in follicular fluid on embryo quality in cases with endometrioma.

Objectives: To analyse levels of reactive oxygen species (ROS) in follicular fluid in patients with endometrioma, and determine their effect on embryo quality and other relevant influencing factors in in-vitro fertilization (IVF) cycles.

Methods: This case-control study was conducted from January 2022 to October 2023 at Hue Centre for Reproductive Endocrinology and Infertility, Hue University Hospital, Vietnam. Enrolled patients undergoing IVF therapy were divided into two groups with a 1:1 ratio: the study group and the control group. Patients diagnosed with endometrioma comprised the study group. The control group included infertile women without ovarian tumours and without low ovarian reserve (POSEIDON criteria). Couples who used a sperm donor were not included in either group.

Results: Forty patients with endometrioma indicated for IVF were recruited into the study group, and an additional 40 patients without endometrioma were selected for the control group. The mean ± standard deviation levels of ROS in follicular fluid in the study group and the control group were comparable at 85.4 ± 28.0 mV and 94.7 ± 20.1 mV, respectively (p = 0.09). The mean fertilization rate in the study group was significantly lower compared with the control group (62.5 % vs 74.5 %; p = 0.032). In the study group, women who also had comorbidity with adenomyosis had a significantly lower total antral follicle count, and numbers of zygotes and blastocysts (p < 0.05). Further examination revealed that endometriosis did not affect the fertilization rate, blastocyst rate or good-quality blastocyst rate (p > 0.05). When considering intervention modalities, the surgical group exhibited the fewest blastocysts overall.

Conclusion: Endometrioma has no impact on ROS in follicular fluid. Fertilization rate, blastocyst rate and IVF outcomes were unaffected by ROS status in patients with endometrioma.