Undiagnosed endometriosis hampers fertility treatment

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Women with undiagnosed endometriosis will have difficulty getting pregnant without IVF, according to a new study.

Women whose endometriosis went undiagnosed until after they began fertility treatment ended up doing more cycles, used treatments that aren’t recommended, and were less likely to have a baby, says Katrina Moss, a researcher at the University of Queensland School of Public Health.

“By contrast, our study found women who were diagnosed with endometriosis before fertility treatment experienced the same outcomes as those without the condition,” Moss says.

In Australia, 1 in 9 women are diagnosed with endometriosis and 40% of these experience infertility.

Moss says Australian women can wait between 4 and 11 years before being diagnosed with endometriosis, and delayed diagnosis reduces the chances of fertility treatments being successful.

“In our national study of 1,322 women, 35% of participants had endometriosis and one-third of those weren’t diagnosed until after they started their fertility treatment,” Moss says.

“Women who were diagnosed late were 4 times more likely to do a lot of cycles, sometime up to 36 cycles of fertility treatment,” she says. “They were also 33% less likely to report a birth.”

Early diagnosis of endometriosis and early access to IVF created a level playing field, as the same outcomes were recorded for women who did not have the condition, says Hayden Homer, a fertility specialist and Centre for Clinical Research professor.

“It is highly advantageous to diagnose endometriosis before starting fertility treatment and to adjust the treatment accordingly,” Homer says.

“Otherwise, women are less likely to have a child and face a higher financial and psychological treatment burden.

“It is critical to remain highly vigilant about the possibility of endometriosis amongst women who are thinking about fertility treatment, especially in the presence of severe pelvic pain.”

This study used data from the Australian Longitudinal Study on Women’s Health (ALSWH).

The paper appears in Human Reproduction.

Source: University of Queensland