This study is part of the European Consortium FEMALE (Finding Endometriosis Through Machine Learning), directed by Dr. Lucky Saraswat, of the Aberdeen Women’s Health Research Center (Great Britain) in collaboration with the Center for Reproductive Health of the University of Edinburgh (Scotland). This team has led the largest and longest population study of this type, analyzing primary, secondary and maternity care files of more than four million women in England, affected by infertility or with symptoms linked to endometriosis, between 1991 and 2020.
Thus, among the 4,041,770 women aged 13 to 50 who consulted in primary care for infertility (245,994 women) or other symptoms of endometriosis, 111 197 have actually received a diagnosis of endometriosis. The overall prevalence of female infertility over the studied period amounts to 48.9 per 1,000 women, with maximum rates in women aged 30 to 39.
Confirmed endometriosis in 6.1 % of infertile women
Among the infertile women, 6.1 % had surgically confirmed endometriosis. Among them, 57.4 % were infertile before diagnosis, which underlines persistent delays in the recognition and diagnosis of endometriosis.
The study reaffirmed a strong association between this pathology and fertility problems, showing that infertile women were more than twice as likely to receive a diagnosis of endometriosis than non -infertile women.
4 out of 10 women diagnosed with endometriosis had pregnancy
The analysis also shows that infertile women in connection with endometriosis are four times more likely to conceive than those whose infertility is due to other causes, such as the dysfunction of ovulation, the “tubal factors” (alterations of the fallopian tubes, preventing the meeting between the ovum and the sperm) or an unexplained infertility. In total, 40.5 % of women diagnosed with endometriosis, regardless of their fertility status, experienced at least one pregnancy during the period studied.
Dr. Saraswat is trying some explanations: “Endometriosis influences fertility in a variable way. Women with light forms often retain good reproductive potential, especially when the disease is diagnosed and taken care of quickly. Average quality scientific data indicate that laparoscopic surgery (via the abdominal cavity, editor’s note) may increase pregnancy rates in certain patients with endometriosis. »»
Another explanatory track, women with a diagnosis of endometriosis are likely to consult earlier, due to a better understanding of the link between endometriosis and infertility.
This data already provides precious comfort to patients. On the condition of making a diagnosis early and offering them suitable therapeutic strategies.
Do not neglect sexual health
If endometriosis negatively affects all stages of fertilization (a reduced implantation of the embryo, less quality of oocytes and embryos …), fertility problems linked to endometriosis often make the impact of the disease on sexual health and sexual disorders. However in endometriosis, awareness of the nervous system can cause pain during reports (dyspareunia), which strongly slows down spontaneous pregnancies. Studies also show pelvic hypersensitivity syndrome, due to a modification of pain pathways and awareness of the central nervous system.
A study quantified this phenomenon, in women with endometriosis, at 56 % deep pain during reports (deep dyspareunia), 60 % chronic pelvic pain, awareness of the nervous system evaluated at 41.4 % and anticipated fear of pain during reports in 66 % of them. Another study also concluded without real surprise that the more the pain during or after the report is intense, the more the frequency of sexual intercourse decreases. Finally, a bad self -image, an anxious or depressive state related to the disease is still aggravated these sexual disorders.
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Source: Health destination
