Not True That Women With Endometriosis Can’t Conceive

The findings of a new study counter the common assertion that women with endometriosis are unlikely to conceive.

Key Points

Highlights:

• Women with endometriosis don’t seem to be unlikely to conceive.

Importance:

• This information counteracts the common assertion that endometriosis hinders the chances a woman with endometriosis to conceive and supports the need for healthcare and information to address all aspects of fertility in women with the disease.

What's done here:

• Researchers conducted a cross-sectional survey of 1,543 women in Australia

Key results:

• Individual contraceptive use was not different among women who reported endometriosis and those who did not. 
• Avoiding pregnancy was less important to women who reported endometriosis compared to those who did not.
• Women reporting endometriosis were around three times more likely to also report a diagnosis of infertility compared to women who did not report endometriosis. 
• Women who reported endometriosis were six times more likely to report taking longer than a year to conceive than women who did not report endometriosis. 
• More women reporting a diagnosis of endometriosis also reported never having been pregnant but the difference was not statistically significant compared to women who did not report endometriosis.
• There were no differences in women's reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth and their report of endometriosis.

Limitations:

• Researchers did not provide the clinical definition of infertility, i.e., the inability to achieve pregnancy after more than 12 months or more of regular unprotected sexual intercourse, to women who took part in the survey. Therefore they could have interpreted infertility differently. 
• Male infertility could have been the cause of the inability to conceive naturally in some cases.
• Some women who have reported endometriosis might not have had a surgical diagnosis and could therefore not actually have endometriosis.
• There might have been a bias in the way women recalled reproductive events although this is unlikely to have been systematic. 

Lay Summary

The common assertion that women with endometriosis are unlikely to conceive is countered by a new study published in The European Journal of Contraception & Reproductive Health Care.

This finding supports the need for healthcare and information to address all aspects of fertility management for women with endometriosis, not just infertility.

For the study, the team led by Dr. Jane Fisher at the School of Public Health and Preventive Medicine at Monash University in Melbourne, Australia conducted a cross-sectional study among 1,543 women. They then compared how women who did and did not report endometriosis managed their fertility.

They found that individual contraceptive use was not different among women who reported endometriosis and those who did not. However, avoiding pregnancy was less important to women who reported endometriosis compared to those who did not (50.5 percent versus 68.7 percent).  In addition, women reporting endometriosis were around three times more likely to report a diagnosis of infertility compared to women who did not report endometriosis. The reason for the majority of these infertility cases was “unexplained female or male infertility”.  Women who reported endometriosis were also six times more likely to report taking longer than a year to conceive than women who did not report endometriosis. 

Although more women reporting a diagnosis of endometriosis also reported never having been pregnant, the difference between women who report endometriosis and those who did not, was not statistically significant. 

Finally, there were no endometriosis-associated differences in women's reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth.

In summary, although women with endometriosis were more likely to have attempted conception and to have experienced difficulties in conceiving and therefore to have used assisted reproduction, there were no differences in having been pregnant, having had a live birth, or having had an unintended pregnancy between women reporting endometriosis and those not reporting endometriosis.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/?term=30481080