Endometriosis and spontaneous hemoperitoneum in pregnancy: evaluation of the magnitude of the risk in women becoming pregnant via in vitro fertilization

Abstract

Objective: To estimate the frequency of Spontaneous Hemoperitoneum in Pregnancy (SHiP) in women with endometriosis achieving pregnancy with IVF. Design: Retrospective case series of women with endometriosis obtaining pregnancy with IVF Setting: A referral academic ART center Patients/Animals: Women with a history of surgery for endometriosis as well as those with ovarian endometriomas or deep endometriotic nodules at the basal transvaginal ultrasound performed prior to initiate the IVF cycle could be included. Women who had a miscarriage before 12 weeks' gestation were excluded. Interventions: Information regarding basal characteristics, IVF cycle and pregnancy outcome was obtained from patients' charts. A binomial distribution model was used to determine the 95%CI of the proportion of SHiP. Main Outcome Measure: Rate of SHiP Results: Overall, 362 pregnancies were included: 238 (66%) had a history of previous surgery for endometriosis and 231 (64%) had endometriosis at ultrasound (107 corresponding to 30% had both). Pregnancies were obtained after fresh and frozen cycles in 244 (67%) and 118 (33%) women, respectively. One case of SHiP was recorded, corresponding to a rate of 0.3% (95%CI: <0.1-1.5%). Conclusions: SHiP is uncommon in the general population of women with endometriosis undergoing IVF. Future studies should better identify risk factors for SHiP in order to disentangle subgroups of women at higher risk.

Women’s quality of sleep and in vitro fertilization success

“…In addition, we collected data on pregnancy outcome and on cumulative live births. This information was obtained through an active and systematic follow-up, as described elsewhere 48 .…”

Endometrial epithelial cells-derived exosomes deliver microRNA-30c to block the BCL9/Wnt/CD44 signaling and inhibit cell invasion and migration in ovarian endometriosis

“…EMs can be anatomically divided into three sub-groups: superficial peritoneal endometriosis, deeply infiltrating endometriosis, and ovarian endometriosis (O-EMs) [ 2 ]. Notably, O-EMs is accompanied by an elevated risk of ovarian cancer [ 3 ], impaired ovarian reserve, and sterility [ 4 ], as well as the failure of in vitro fertilization [ 5 ]. EMs, as a benign disease, present similar biological characteristics with cancers like invasive and migratory properties, development of local and distant foci, and resistance to apoptosis [ 6 , 7 ].…”

Effects of Breastfeeding on Endometriosis-Related Pain: A Prospective Observational Study

“…Its dependence on sex hormones is also confirmed by the evidence that hormonal therapy can delay surgery, control pain, and prevent recurrence; however, pain often recurs after treatment discontinuation [15]. Pregnancy has a positive effect on endometriosis and its associated pain due to hormonal changes [16], but obstetric complications have been reported in affected patients [17][18][19][20][21][22][23][24].…”

“…However, the increased risk of obstetric complications in women with endometriosis including adverse outcomes of pregnancy and a higher rate of cesarean sections [16][17][18][19][20][21][22][23][30][31][32] may cause a delay in the onset of breastfeeding and thus hinder exclusive breastfeeding in these women [33].…”