Does Endometriosis Cause Infertility?

It is a question of localization, study suggests

Key Points

Highlights

• The localization of the lesions is key in determining whether or not endometriosis will lead to infertility and cause pain.

Importance

• This finding could help clinicians in their decision making when consulting women with endometriosis. 

What's Done Here:

• The relationship between pelvic pain, infertility, and the localization of endometriosis was examined in 430 fertile and infertile women from Iran. 
• The study was performed on patients who underwent diagnostic laparoscopy for either infertility (383 women) or pelvic pain (30 women.)
• The symptoms of endometriosis between fertile and infertile women were compared with the localization of endometriosis.

Key results

• There is no statistically significant difference in the overall prevalence of endometriosis between women who are fertile or infertile.
• There is no relationship between the endometriosis stage and the frequency of painful periods or pelvic pain. 
• Painful periods and pelvic pain are significantly more common among women with ovarian and peritoneal endometriosis. 
• Infertility is more prevalent among women who have peritoneal endometriosis than those who have ovarian endometriosis.

Limitations of the study

• The study involved 430 women with endometriosis, of whom only 30 (seven percent) were fertile. 

Lay Summary

Infertility may be related to the localization of endometriosis involvement according to a study published in the Journal of Obstetrics and Gynaecology. This finding is in agreement with the results of previous studies and could help clinicians in their decision making about the treatment of infertile women with a diagnosis of endometriosis.

To better analyze the relationship between pelvic pain, infertility, and the localization of endometriosis lesions, a team of researchers from Iran assessed the prevalence of endometriosis in 430 fertile and infertile women. 

All women were referred to the Diagnostic Laparoscopy Unit between January 2012 and January 2013 either because of infertility (383 women) or pelvic pain (30 women).

The researchers compared the symptoms of endometriosis between fertile and infertile women. They found that there was no statistically significant difference in the overall prevalence of endometriosis among the women.

The researchers categorized endometriosis according to the localization of the lesions as peritoneal, ovarian, and ovarian coexisting with peritoneal, and disease stage (as early or late). They found that there was no relationship between the stage of the disease and the frequency of painful periods or pelvic pain but that pain was significantly more common among women with ovarian and peritoneal endometriosis. 

Importantly, the researchers found that infertility was more prevalent among women who had peritoneal endometriosis compared to those with ovarian endometriosis. 

“The results of this study could have clinical application in the consultation and decision-making in infertile women with an endometriosis diagnosis,” the researchers wrote but added, “further studies with a larger sample size are required to confirm these findings”.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29390906