A prospective cohort study of endometriosis and subsequent risk of infertility

Prescott, Jennifer; Farland, Leslie V.; Tobias, Deirdre K; Gaskins, Audrey J.; Spiegelman, Donna; Chavarro, Jorge E.; Rich‐Edwards, Janet W.; Barbieri, Robert L.; Missmer, Stacey A.

doi:10.1093/humrep/dew085

Cited by 213 publications

(164 citation statements)

References 41 publications

(49 reference statements)

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“…We examined the overall and age group-specific prevalence of DE as self-reported by survey respondents, the symptomatic burden, method of diagnosis, and most common comorbidities experienced by women with DE. The prevalence of DE was 6.1% among survey respondents, which despite being less than the 10% commonly reported in the literature [8,9] , falls within the range of approximately 6-10% used for describing endometriosis prevalence among the general population [2,5,6] . The fact that our estimates are on the lower end of the range is not surprising because our study focused on diagnosed prevalence rather than overall (diagnosed and undiagnosed) prevalence, which has been estimated at up to 45% in studies of women undergoing laparoscopic surgery for infertility, sterilization, acute pelvic pain, or other indications [8,10] .…”

Section: Discussionmentioning

confidence: 88%

“…Symptoms of endometriosis include pelvic pain, menstrual cramps, painful intercourse, and abnormal/irregular uterine bleeding [1] . Endometriosis is also associated with a higher risk of subsequent infertility among women <35 years of age [2] . The symptoms of endometriosis are highly variable and not always diagnostic, leading to a considerable delay in diagnosis [3] .…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Fuldeore

Soliman²

2016

Gynecol Obstet Invest

211

170

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Background/Aims: To estimate the prevalence of diagnosed endometriosis (DE) in women in the United States and assess the associated symptomatic burden. Methods: An online, cross-sectional survey of women aged 18-49 years was conducted from August 6, 2012, through November 14, 2012. Survey data (weighted by age, race, education, income, geographical distribution, and propensity score) were used to estimate the prevalence and symptomatic burden of DE in women in the United States. Weighted logistic regressions were used to assess differences in symptom burden between women with and without endometriosis. Results: The prevalence of DE was estimated at 6.1% (2,922 of 48,020 women surveyed); 52.7% of women were 18-29 years of age when they were diagnosed with endometriosis. Most (86.2%) women experienced symptoms before diagnosis. More women with (vs. without) DE had menstrual pelvic pain/cramping (52.7 vs. 45.2%), non-menstrual pelvic pain/cramping (36.7 vs. 14.3%), infertility (11.6 vs. 3.4%), and dyspareunia (29.5 vs. 13.4%). Women with endometriosis were also more likely to report severe symptoms (OR (95% CI) 2.7 (2.3-3.1) for menstrual pelvic pain/cramping, 2.2 (1.7-2.9) for non-menstrual pelvic pain/cramping, and 2.4 (1.8-3.2) for dyspareunia). Conclusion: The prevalence of DE among US women is notable, and affected women experience a substantial symptom burden.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Fuldeore

Soliman²

2016

Gynecol Obstet Invest

211

170

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“…İlginç olarak aradaki fark sadece 35 yaş altı kadınlarda görülmüş, bu da yaşla gelen diğer faktörlerin endometriozisin getirdiği farkı silerek anlamsız hale getirdiğini düşündürmüştür. 2 İleri evre endometriozisin (ASRM Evre III ve IV) neden infertiliteye yol açtığını açıklayacak nedenler bellidir. Bu kadınlarda pelvik anatomi, oluşan yapışıklıklar nedeniyle ciddi derecede hasara uğrar.…”

Section: ö öZ Ze Et Tunclassified

Management of Infertility in Women with Endometriosis

Sarıdoğan¹,

Saridogan²

2017

TJRMS

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ndometriozis, infertil kadınlarda sıklıkla karşılaştığımız bir durumdur ancak endometriozisle infertilite arasındaki bağlantı hala tartışmalıdır. Laparoskopi, yüksek rezolüsyonlu ultrasonografi ve manyetik rezonans görüntüleme gibi kullanılan tanısal yöntemlerin zaman içinde gelişimi, tetkik edilen endometriozis tipini giderek değiştirmiştir. Bunun yanında, laparoskopik cerrahi ve yardımcı üreme tekniklerindeki gelişmeler de kullanılan tedavi yaklaşımlarını giderek değiştirmekte, bazen bu değişimin hızı Endometriozisin gelecekte infertilite riskini artırdığına dair ikna edici birçok kanıt vardır. Erken evre endometrioziste azalmış fertilitenin patogenezi tam olarak bilinmemekle birlikte evre III ve IV endometriozisteki pelvik anatomi distorsiyonunun infertiliteden sorumlu olduğu düşünülmektedir. Hem erken ve hem de ileri evre endometriozis için yapılan laparoskopik cerrahi spontan gebelik oranlarını iyileştirmekte yararlıdır. Açıklanamayan infertilitesi olanlar dışındaki iyi over rezervli genç kadınlarda cerrahi ilk seçenek olabilir. Erkek faktör infertilitesi veya tubal hasar birlikteliği ya da diğer yaklaşımların başarısızlığı söz konusu olduğunda endometriozis ilişkili subfertilitede yardımcı üreme teknikleri tercih edilecek tedavidir. Diğer tanısal kategorilere kıyasla endometriozisli kadınlarda yardımcı üreme tekniklerinin klinik gebelik oranları daha düşük görünse de, geniş ulusal veritabanlarından alınan verilerin sonuçları bunun aksini göstermektedir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Endometriozis; infertilite; yönetim A AB BS S T TR RA AC CT TThere is convincing evidence that endometriosis increases future risk of infertility. The pathogenesis of reduced fertility in early endometriosis is not clearly known but distortion to pelvic anatomy in stage III and IV endometriosis is likely to be responsible for infertility. Laparoscopic surgery for both early and advanced endometriosis is beneficial in improving spontaneous conception rates. Surgery may be the first choice in young women with good ovarian reserve and otherwise unexplained infertility. However, assisted reproductive technology (ART) is the preferred treatment in endometriosis associated subfertility when there is concomitant male factor infertility or tubal damage or when other approaches have failed. Clinical pregnancy rates of ART may be lower in women with endometriosis compared to other diagnostic categories, however this is disputed on the basis of data from large national databases. ART does not appear to increase the risk of recurrent endometriosis. Ya zış ma Ad re si/Cor res pon den ce:

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“…Endometriosis is a major cause of infertility and women with endometriosis are twice as likely to have infertility [4] [5]. The correlation between endometriosis and infertility has not been clearly verified; damage to the anatomical relationship between the ovaries and the fallopian tubes due to serious endometriosis may be strongly suspected as the cause of infertility, but the association of a mild condition of endometriosis that is not accompanied by such anatomical damage with infertility is very controversial.…”

Section: Introductionmentioning

confidence: 99%

DNA Microarray Analysis of Gene Expression in Eutopic Endometrium from Patients with Endometriosis

Hwang¹,

Choi²,

Kim³

et al. 2017

ARSci

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Pathogenesis of the endometriosis is complex and the etiology is still unclear. The objective of this study was to examine that endometrial gene expression in late secretory phase endometrium differs between patients with and without endometriosis. Five patients with proven advanced-stage endometriosis and 5 controls underwent endometrial biopsy in the late secretory phase. Analysis of eutopic endometrial gene expression was performed using Affymetrix gene arrays and differentially expressed genes were assigned to gene ontology groups based on overrepresented analysis using Database for Annotation, Visualization, and Integrated Discovery software. Four hundred sixty two genes were identified as up-regulated such as matrix metalloproteinase 10, cytochrome P450 family 24 subfamily A polypeptide 1, matrix metalloproteinase 3, chemokine (C-C motif) ligand 20, Rho family GTPase 1, interleukin 1-beta, and insulin-like growth factor binding protein 1. Six hundred forty three genes were down-regulated in all endometriotic samples. A lot of genes related with metabolic process, cellular ketone metabolic process and ncRNA metabolic processing were included. Expression patterns of selected five genes were validated by quantitative real time PCR. The results of this analysis support that the eutopic endometrium from patients with advanced-stage endometriosis has distinct gene expression profile from eutopic endometrium of control without endometriosis.

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A prospective cohort study of endometriosis and subsequent risk of infertility

Abstract: This work was supported by the National Institutes of Health (grant numbers: UM1 CA176726, HD52473, HD57210, T32DK007703, T32HD060454, K01DK103720). We have no competing interests to declare.

Cited by 213 publications

References 41 publications

Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women

Management of Infertility in Women with Endometriosis

DNA Microarray Analysis of Gene Expression in Eutopic Endometrium from Patients with Endometriosis

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