Does Getting Pregnant Really Help When You Have Endometriosis?

"Getting pregnant help to reduce endometriosis symptoms", is this really so?

Key Points

Highlights:

• Pregnancy has a positive effect on the size of deep infiltrating endometriosis lesions.

Importance:

• This finding questions the need to systematically perform surgery on patients with deep infiltrating endometriosis before they become pregnant.

What's done here:

• Using MRI, researchers analyzed the size of deep infiltrating lesions of 21 women before and after pregnancy.

Key results:

• The mean overall deep infiltrating endometriosis lesion volume was significantly higher before pregnancy compared to after pregnancy.
• The mean volume of each patient’s largest lesion was significantly higher before pregnancy compared to after pregnancy.
• These differences were both statistically significant.

Limitations:

• The researchers did not have any information about the hormonal cycle of the women or whether or not they breastfed after delivery.
• Deep infiltrating endometriosis lesions are not expected to be influenced by hormone levels, but there is still a possibility that the menstrual phase may have an effect on them.
• Breastfeeding may have an impact on endometriosis lesions and may skew the findings in one way or the other.
• MRI does not always reflect the exact surgical findings in the patients, fibrosis or endometriosis should be evaluated histopathologically from surgically resected specimens.

Lay Summary

Pregnancy has a favorable impact on the volume of deep infiltrating endometriosis lesions according to a study published in the scientific journal "PLoS One". This is the first study that demonstrates such a favorable impact of pregnancy on endometriosis lesion volume.

For the study, researchers led by the French researcher Dr. Charles Chapron compared the volume of deep infiltrating endometriosis lesions before and after pregnancy. They did this using magnetic resonance imaging (MRI), an imaging technique that uses a magnetic field to generate detailed images of organs and tissues in the body.  

Chapron and colleagues analyzed a total of 21 women who had not had endometriosis surgery in the past. They performed two sets of MRI examinations, one before and one after pregnancy. The 21 women had a total of 67 lesions. The researchers found that on average, the lesions were significantly larger before pregnancy compared to after pregnancy; the mean volume of the lesions before pregnancy was 2.5 mm3 while it was1.7 mm3 after pregnancy.

The researchers also compared the mean volume of each patient’s largest lesion and found, once again, that this was significantly larger before pregnancy compared to after pregnancy.

“This study demonstrates, for the first time, a favorable effect of pregnancy on the volume of DIE lesions, which regressed significantly after pregnancy based on MRI evaluation,” the researchers wrote. They added that longer follow-up is needed to better evaluate the change in deep infiltrating endometriosis lesions during and after pregnancy.

Even though this study did not assess the severity of endometriosis symptoms such as chronic pelvic pain, and painful periods, it showed for the first time, that pregnancy can have a favorable effect on the size of endometriotic lesions.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/31584969