Endometriosis and infertility

doi:10.1016/j.fertnstert.2006.08.014

Cited by 84 publications

(34 citation statements)

References 36 publications

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“…The population cohort was defined to be at risk for endometriosis (currently menstruating) and opportunity for diagnosis (residence in the clinical catchment area) in an attempt to overcome key methodologic challenges underlying endometriosis research that requires adherence to the gold standard of visualized disease. 28,29 More complete details regarding the design and methodology of the ENDO Study are provided elsewhere. 17 …”

Section: Methodsmentioning

confidence: 99%

“…29 A computerized algorithm was also developed for the automatic calculation of severity and categorized as stage 1 (minimal) to 4 (severe) disease.…”

Section: Methodsmentioning

confidence: 99%

“…rASRM staging was categorized as: stage I, minimal (scores 1–5); stage II, mild (scores 6–15); stage III, moderate (scores 16–40); or stage IV, severe (scores >40). 29 …”

Section: Methodsmentioning

confidence: 99%

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Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study

Peterson¹,

Johnstone²,

Hammoud³

et al. 2013

American Journal of Obstetrics and Gynecology

103

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OBJECTIVE We sought to identify risk factors for endometriosis and their consistency across study populations in the Endometriosis: Natural History, Diagnosis, and Outcomes (ENDO) Study. STUDY DESIGN In this prospective matched, exposure cohort design, 495 women aged 18–44 years undergoing pelvic surgery (exposed to surgery, operative cohort) were compared to an age- and residence-matched population cohort of 131 women (unexposed to surgery, populationcohort). Endometriosis was diagnosed visually at laparoscopy/laparotomy or by pelvic magnetic resonance imaging in the operative and population cohorts, respectively. Logistic regression estimated the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for each cohort. RESULTS The incidence of visualized endometriosis was 40% in the operative cohort (11.8% stage 3–4 by revised criteria from the American Society for Reproductive Medicine), and 11% stage 3–4 in the population cohort by magnetic resonance imaging. An infertility history increased the odds of an endometriosis diagnosis in both the operative (AOR, 2.43; 95% CI, 1.57–3.76) and population (AOR, 7.91; 95% CI, 1.69–37.2) cohorts. In the operative cohort only, dysmenorrhea (AOR, 2.46; 95% CI, 1.28–4.72) and pelvic pain (AOR, 3.67; 95% CI, 2.44–5.50) increased the odds of diagnosis, while gravidity (AOR, 0.49; 95% CI, 0.32–0.75), parity (AOR, 0.42; 95% CI, 0.28–0.64), and body mass index (AOR, 0.95; 95% CI, 0.93–0.98) decreased the odds of diagnosis. In all sensitivity analyses for different diagnostic subgroups, infertility history remained a strong risk factor. CONCLUSION An infertility history was a consistent risk factor for endometriosis in both the operative and population cohorts of the ENDO Study. Additionally, identified risk factors for endometriosis vary based upon cohort selection and diagnostic accuracy. Finally, endometriosis in the population may be more common than recognized.

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Section: Methodsmentioning

confidence: 99%

“…29 A computerized algorithm was also developed for the automatic calculation of severity and categorized as stage 1 (minimal) to 4 (severe) disease.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study

Peterson¹,

Johnstone²,

Hammoud³

et al. 2013

American Journal of Obstetrics and Gynecology

103

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“…The results of studies focusing on treatment options for different stages of endometriosis are conflicting, even when involving identical treatment approaches [9,20,21]. Thus, it is possible that the patients with the same disease stage according to the ASRM classification are actually not comparable when it comes to symptoms and activity of endometriosis [2,22].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of minimal and mild endometriosis, there is no clear view about the usefulness of GnRH therapy [20,21]. Furthermore, the information available about the activity of endometriotic lesions in minimal to mild endometriosis is very scarce [9].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Rate in Endometriosis Patients according to the Severity of the Disease after Using a Combined Approach of Laparoscopy, GnRH Agonist Treatment and in vitro Fertilization

Sõritsa

Saare²,

Laisk³

et al. 2014

Gynecol Obstet Invest

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Aim: To evaluate the effects of combined treatment approaches on endometriosis-associated infertility in different stages of endometriosis using laparoscopy, gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and in vitro fertilization (IVF). Methods: This retrospective study was carried out on 179 women with surgically confirmed endometriosis. Patients were divided into subgroups: group 1 (stage I-II, n = 121) and group 2 (stage III-IV, n = 58). Patients eligible for IVF, who were found to have adenomyosis or moderate to severe endometriosis, were also given postoperative GnRHa. Pregnancy and delivery rates were cumulatively calculated during 5 years according to the severity of the disease. Results: The overall pregnancy, delivery and miscarriage rates were 66.5, 56.4 and 15.1%, respectively, for all patients following spontaneous and assisted conception. There were no significant differences in reproductive outcomes between the study groups. The pregnancy and delivery rates were also comparable within group 1 between the patients with and without GnRHa treatment. Conclusion: Pregnancy and delivery rates at different stages of endometriosis were not affected by the different approaches used for infertility treatment, with >60 and >50% of patients having conceived and delivered a baby, respectively, in both groups. The usefulness of GnRHa treatment for endometriosis patients with minimal to mild forms is questionable and deserves further studies.

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