Follicular development in spontaneous and stimulated cycles in women with minimal-mild endometriosis

Abstract

Objective: To study follicle development in women with minimal-mild endometriosis.

Design: In women with endometriosis a spontaneous ovulatory cycle was compared with two subsequent cycles in which either clomiphene or clomiphene and FSH were given to stimulate folliculogenesis. Spontaneous cycles in women with tubal infertility provided a comparison group.

Setting: Infertility clinic, Aberdeen Maternity Hospital.

Subjects: 17 women with minimal-mild endometriosis and 10 women with tubal infertility.

Interventions: The women with endometriosis were treated with 150 mg clomiphene citrate from days 2 to 6 in one cycle and in a subsequent cycle with 150 mg clomiphene citrate on days 2 to 6 plus 75 iu FSH daily thereafter.

Main outcome measures: Follicular size measured daily using ultrasound. Serum FSH estimated on days 5 and 7 and then daily.

Results: Spontaneous follicular growth in the women with endometriosis was similar to that in the women with tubal infertility. Follicular development began earlier in cycles with clomiphene/FSH and the leading follicle reached 16 mm 2 days sooner but the rate of growth was similar whether or not either regimen of stimulation was used.

Conclusion: Follicular growth is not impaired by minimal-mild endometriosis. Infertility with this condition cannot be explained by altered follicular growth or responsiveness.