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Undiagnosed endometriosis affects fertility treatment outcomes

11 October 2021
Appeared in BioNews 1116

Having undiagnosed endometriosis can lead to a lower chance of having a baby following fertility treatment, compared to women who have endometriosis, but have had it diagnosed before starting treatment.

Women with endometriosis were found to experience the same birth rate following fertility treatment as those without the condition, provided it had been diagnosed prior to starting treatment, according to a retrospective longitudinal cohort study published in the journal Human Reproduction. In cases where endometriosis had not been diagnosed, women were more likely to undergo extensive, unsuitable treatments, and less likely to successfully get pregnant. 

'In our national study of 1322 women, 35 percent of participants had endometriosis and one third of those weren't diagnosed until after they started their fertility treatment' said Dr Katrina Moss, a public health researcher at the University of Queensland, Australia, who led the study.

'Women who were diagnosed late were four times more likely to do a lot of cycles, sometimes up to 36 cycles of fertility treatment', she continued. 'They were also 33 percent less likely to report a birth.'

Endometriosis is a chronic inflammatory condition where endometrial tissue, which normally lines the uterus, grows in other places, including in the ovaries and fallopian tubes and other organs. It is estimated that 10 percent of reproductive-age women worldwide suffer from the condition, which is associated with symptoms including pelvic and back pain, heavy or irregular periods, and depression.

While the causes of endometriosis are not entirely known, it can affect women of any age and has long been associated with difficulties in getting pregnant.

In these cases, assisted reproductive treatment is recommended for those wishing to conceive. However, this research highlights the importance of noticing the signs of endometriosis early and providing early and suitable treatment access to those with the condition.

'It is highly advantageous to diagnose endometriosis before starting fertility treatment and to adjust the treatment accordingly' said Professor Hayden Homer, a fertility specialist at the University of Queensland who also contributed to the study. 'Otherwise, women are less likely to have a child and face a higher financial and psychological treatment burden.'

While the study was not able to account for the severity of endometriosis cases, or the link between treatment and birth, the authors clarify that this research demonstrates where the discrepancies in outcome, caused by endometriosis, can be decreased.

'Knowing about your diagnosis levelled the playing field' said Dr Moss, in an interview with ABC News. 'I would just really love other women to know they're not alone in what they're going through and that early diagnosis does make a difference for some women.'

SOURCES & REFERENCES
Delayed diagnosis of endometriosis disadvantages women in ART: a retrospective population linked data study
Human Reproduction |  6 October 2021
Undiagnosed endometriosis compromises fertility treatment
The University of Queensland Australia |  6 October 2021
Undiagnosed endometriosis hampers fertility treatment
Futurity |  6 October 2021
Undiagnosed endometriosis leads to increased infertility, study finds
Women's Agenda |  6 October 2021
Women with undiagnosed endometriosis worse off when undergoing fertility treatment, study finds
ABC News Australia |  5 October 2021
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