Undiagnosed endometriosis leads to infertility

One-third of ladies using fertility treatments are being diagnosed with endometriosis after they start, with late opinion reducing their chance of getting a successful pregnancy.

Katrina Moss, a public health researcher from the University of Queensland, is the lead author of the study, published in the journal, Human Reproduction.

Doctor Moss said up to forty per cent of ladies with endometriosis will need fertility treatment compared to women without endometriosis.

The condition, where endometrial tissue grows outside of the uterus, affects one in nine women in Australia and on average takes 6.5 years to be diagnosed.

Women with undiagnosed Endometriosis.

“For ladies who had endometriosis but did not realize it when they started their fertility treatment, they were just worse off,” Doctor Moss said.

“They did more cycles, they were more likely to use intrauterine insemination (IUI), compared to in-vitro fertilisation (IVF), which is the recommended treatment.”

According to her research, these women were also thirty-three per cent less likely to conceive a baby compared to women without endometriosis.

Women with diagnosed Endometriosis.

Still, the research also found that women who knew about their endometriosis before starting fertility treatment were no difference in any outcome compared to women without the condition.

“Knowing about your diagnosis levelled the playing field,” Dr Moss told the ABC’s, Emma Pollard.

How successful is In vitro fertilisation?

Doctor Moss explained that she has personal experience with endometriosis, she was diagnosed with the condition in her twenties. She has been through twelve cycles of In Vitro Fertilization and seven embryo transfers, without success.

• “The success rate for things like In Vitro Fertilization is fairly low, you would not wish it on your worst enemy, it is a very tough process,” she said. “It is not what I might have planned and it is not what I chose.” “I might just really love other women to understand they are not alone in what they are going through which early diagnosis does make a difference for a few women.”

• Doctor Moss said the ladies in her study with undiagnosed endometriosis “did so multiple more cycles than women who knew about it”. “Once you take under consideration the financial and emotional burden of that, they are just going through most added that they did not need to undergo if that they had this data at the beginning,” she said.

• “Fertility treatment is hard and it is indeed tougher if you have undiagnosed endometriosis.”

Doctor Moss’ study used data from the Australian Longitudinal Study on Women’s Health and focused on the experiences of ladies who used Assisted Reproductive Technology ( ART).

Another Study on infertility

Hayden Homer, a Brisbane- based fertility specialist, said it had been the first study of it is kind in Australia to look at the “real-life impact of endometriosis on fertility”.

“This group of patients were followed up for twenty years. So it is a representative data assail how their fertility progressed and therefore the way endometriosis impacted,” Professor Homer told the ABC.

He believes In Vitro Fertilization may be a “ superior treatment” for ladies with endometriosis over “ simpler forms” of assisted reproduction like IUI, since endometriosis is assumed to cause “ very high levels of inflammation within the pelvis”.

“Therein atmosphere, if sperm and eggs are exposed thereto inflammatory response, their ability to form an embryo which can plant is affected,” Professor Homer said.

“ So if you probably did In Vitro Fertilization, you remove the eggs and sperm from that atmosphere and that they are put together within the lab and therefore the embryos are cultured outside of that level of inflammation.”

Professor Homer does not believe all women with fertility issues should be lining up to urge surgical testing for endometriosis.

“The only way to definitively diagnose a majority of endometriosis is to possess a laparoscopy, which is sort of invasive,” he said.

“We were not saying everyone who features a fertility problem should have a laparoscopy which is because supported this study and consistent with other data only about thirty-five per cent of girls seeking ART have endometriosis.”

Still, two out of three people would have an unnecessary operation, “If we did laparoscopy for everybody .”

Professor Homer noted pain as a “ red flag” for endometriosis.

“ Significant pain that keeps you off work, pain with intercourse, pain with opening the bowels then on.”

He remarked that for ladies with those symptoms an ultrasound checkup “ may be a veritably good original quite screening process and you would prioritise for farther disquisition”.

SOURCE
https://womensagenda.com.au/life/health/undiagnosed-endometriosis-leads-to-increased-infertility-study-finds/