Pregnancy Complications Associated with Endometriosis

An association between endometriosis and infertility has been confirmed by a large number of studies, although mechanisms are still debated. The availability of in vitro fertilization represented a major step forward in achieving pregnancy in women with endometriosis, although in both peritoneal and ovarian disease, there is an adverse effect on ovulation rates, markers of ovarian reserve, and response to ovarian stimulation. Results have improved using intracytoplasmic sperm injection. When achieved, pregnancy may be complicated by spontaneous hemoperitoneum, a rare but potentially fatal event. Data on incidence of preeclampsia, small for gestational age (SGA), and preterm birth are not univocal. A large cohort study found an increased risk of preterm birth; another observed no evidence for an association between endometriosis and risk of pregnancy hypertension, or preeclampsia; a third found increased rates of both preterm birth and SGA. In pregnancies complicated by the presence of ovarian endometrioma no differences have been observed in late pregnancy and neonatal outcomes. Endometriosis patients seem to be at an increased risk of placenta previa and postpartum hemorrhage. An association has been found also when pregnancy is achieved through in vitro fertilization, suggesting that events around the time of implantation may be responsible. With regard to pathophysiology, the hypothesis has been proposed that defective spiral artery remodeling may be the cause of major obstetrical syndromes in endometriosis and adenomyosis and that endometrial and myometrial junctional zone (MJZ) abnormalities represent a risk factor for the vascular development of the placental bed. Available evidence supports the idea of a reversibility of MJZ changes by appropriate medication inducing a prolonged hypoestrogenic period. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

McGoogan LS. Sterility and endometriosis. Arch Surg. 1949;59:437–44. Kistner RW. Endometriosis and infertility. Clin Obstet Gynecol. 1959;2:877–89. Carvalho LFP, Rossener R, Azeem A, Malvezzi H, Simões Abrão M, Agarwal A. From conception to birth: how endometriosis affects the development of each stage of reproductive life. Minerva Ginecol. 2013;65:181–98. de Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376:730–8. Verkauf BS. Incidence, symptoms, and signs of endometriosis in fertile and infertile women. J Fla Med Assoc. 1987;74(9):671–5. Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. Fertil Steril. 2012;98:591–8. Macer ML, Taylor HS. Endometriosis and infertility. A review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin North Am. 2012;39:535–49. Reis FM, Petraglia F, Taylor RN. Endometriosis: hormone regulation and clinical consequences of chemotaxis and apoptosis. Hum Reprod Update. 2013;19:406–18. Shah DK. Diminished ovarian reserve and endometriosis: insult upon injury. Semin Reprod Med. 2013;31:144–9. Loh FH, Tan AT, Kumar J, Ng SC. Ovarian response after laparoscopic ovarian cystectomy for endometriotic cysts in 132 monitored cycles. Fertil Steril. 1999;72:316–21. Horikawa T, Nakagawa K, Ohgi S, Kojima R, Nakashima A, Ito M, et al. The frequency of ovulation from the affected ovary decreases following laparoscopic cystectomy in infertile women with unilateral endometrioma during a natural cycle. J Assist Reprod Genet. 2008;25:239–44. Tinkanen H, Kujansuu E. In vitro fertilization in patients with ovarian endometriomas. Acta Obstet Gynecol Scand. 2000;79:119–22. Donnez J, Wyns C, Nisolle M. Does ovarian surgery for endometriomas impair the ovarian response to gonadotropin? Fertil Steril. 2001;76:662–5. Demirol A, Guven S, Baykal C, Gurgan T. Effect of endometrioma cystectomy on IVF outcome: a prospective randomized study. Reprod Biomed Online. 2006;12:639–43. Lin X-N, Wei M-L, Tong X-M, Xu W-H, Zhou F, Huang Q-X, Wen G-F, Zhang S-Y. Outcome of in vitro fertilization in endometriosis-associated infertility: a 5-year database cohort study. Chin Med J. 2012;125:2688–93. Hock DL, Sharafi K, Dagostino L, Kemmann E, Seifer DB. Contribution of diminished ovarian reserve to hypofertility associated with endometriosis. J Reprod Med. 2001;46:7–10. Hauzman EE, Garcia-Velasco JA, Pellicer A. Oocyte donation and endometriosis: what are the lessons? Semin Reprod Med. 2013;31:173–7. Opøien HK, Fedorcsak P, Omland AK, Abyholm T, Bjercke S, Ertzeid G, Oldereid N, Mellembakken JR, Tanbo T. In vitro fertilization is a successful treatment in endometriosis-associated infertility. Fertil Steril. 2012;97:912–8. Benagiano G. Brosens I, Habiba M. Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum Reprod Update. 2014;20(3):386–402. Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S, Buy JN. Pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology. 2004;232:379–89. Bazot M, Fiori O, Darai E. Adenomyosis in endometriosis – prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod. 2006;21:1101–2. Author reply 1102–3. Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G. Adenomyosis in endometriosis -Prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod. 2005;20:2309–16. Kunz G, Herbertz M, Beil D, Huppert G, Leyendecker G. Adenomyosis as a disorder of the early and late human reproductive period. Reprod Biomed Online. 2007;15:681–5. Benagiano G, Brosens I. Adenomyosis and Endometriosis have a common origin. J Obstet Gynaecol India. 2011;61:146–53. Ginsburg KA, Valdes C, Schnider G. Spontaneous uteroovarian vessel rupture during pregnancy: three case reports and a review of the literature. Obstet Gynecol. 1987;69:474–6. Brosens JJ, Parker MG, McIndoe A, Pijnenborg R, Brosens IA. A role for menstruation in preconditioning the uterus for successful pregnancy. Am J Obstet Gynecol. 2009;200:615. e1–615.e6. Moen MH, Muus KM. Endometriosis in pregnant and nonpregnant women at tubal sterilization. Hum Reprod. 1991;6:699–702. Fiadjoe P, Thomas-Phillips A, Reddy K. Massive haemoperitoneum due to uterine artery erosion by endometriosis and a review of the literature. Gynecol Surg. 2008;5:133–5. O’Leary SM. Ectopic decidualization causing massive postpartum intraperitoneal hemorrhage. Obstet Gynecol. 2006;108:776–9. Uri FI, Opaneye A. Haemoperitoneum due to cornual endometriosis after laparoscopic sterilisation. Br J Obstet Gynaecol. 1979;86:664–5. Clement PB. Perforation of the sigmoid colon during pregnancy: a rare complication of endometriosis. Case report. Br J Obstet Gynaecol. 1977;84:548–50. Gini PC, Chukudebelu WO, Onuigbo WI. Perforation of the appendix during pregnancy: a rare complication of endometriosis. Case report. Br J Obstet Gynaecol. 1981;88:456–8. Loverro G, Cormio G, Greco P, Altomare D, Putignano G, Selvaggi L. Perforation of the sigmoid colon during pregnancy: a rare complication of endometriosis. J Gynecol Surg. 1999;15:155–7. Brosens JJ, Gellersen B. Death or survival—progesterone-dependent cell fate decisions in the human endometrial stroma. J Mol Endocrinol. 2006;36:389–98. Burney RO, Talbi S, Hamilton AE, Vo KC, Nyegaard M, Nezhat CR, et al. Gene expression analysis of endometrium reveals progesterone resistance and candidate susceptibility genes in women with endometriosis. Endocrinology. 2007;148:3814–26. Kortelahti M, Anttila MA, Hippelainen MI, Heinonen ST. Obstetric outcome in women with endometriosis – a matched case-control study (2003). Gynecol Obstet Invest. 2003;56:207–12. Brosens IA, De Sutter P, Hamerlynck T, Imeraj L, Yao Z, Cloke B, Brosens JJ, Dhont M. Endometriosis is associated with a decreased risk of pre-eclampsia. Hum Reprod. 2007;22:1725–9. Stephansson O, Kieler H, Granath F, Falconer H. Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome. Hum Reprod. 2009;24:2341–7. Hadfield RM, Lain SJ, Raynes-Greenow CH, Morris JM, Roberts CL. Is there an association between endometriosis and the risk of pre-eclampsia? A population based study. Hum Reprod. 2009;24:2348–52. Fernando S, Breheny S, Jaques AM, Halliday JL, Baker G, Healy D. Preterm birth, ovarian endometriomata, and assisted reproduction technologies. Fertil Steril. 2009;91:325–30. Brosens I, Derwig I, Brosens J, Fusi L, Benagiano G, Pijnenborg R. The enigmatic uterine junctional zone: The missing link between reproductive disorders and major obstetrical disorders? Hum Reprod. 2010;25:569–74. Kim YM, Chaiworapongsa T, Gomez R, Bujold E, Yoon BH, Rotmensch S, Thaler HT, Romero R, et al. Failure of physiologic transformation of the spiral arteries in the placental bed in preterm premature rupture of membranes. Am J Obstet Gynecol. 2002;187:1137–42. Kim YM, Bujold E, Chaiworapongsa T, Gomez R, Yoon BH, Thaler HT, Rotmensch S, Romero R. Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 2003;189:1063–9. Juang C-M, Chou P, Yen M-S, Twu N-F, Horng H-C, Hsu W-L. Adenomyosis and risk of preterm delivery. Br J Obstet Gynaecol. 2007;114:165–9. Rossman F, D'Ablaing 3rd G, Marrs RP. Pregnancy complicated by ruptured endometrioma. Obstet Gynecol. 1983;62:519–21. Benaglia L, Bermejo A, Somigliana E, Scarduelli C, Ragni G, Fedele L, Garcia-Velasco JA. Pregnancy outcome in women with endometriomas achieving pregnancy through IVF. Hum Reprod. 2012;27:1663–7. Garcia-Velasco JA, Somigliana E. Management of endometriomas in women requiring IVF: to touch or not to touch. Hum Reprod. 2009;24:496–501. Qiu JJ, Liu M-H, Zhang Z-X, Chen L-P, Yang Q-C. Transvaginal color Doppler sonography predicts ovarian interstitial fibrosis and microvascular injury in women with ovarian endometriotic cysts. Acta Obstet Gynecol Scand. 2012;91:605–12. Healy DL, Breheny S, Halliday J, Jaques A, Rushford D, Garrett C, Talbot JM, Baker HWG. Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia. Hum Reprod. 2010;25:265–74. Takemura Y, Osuga Y, Fujimoto A, Oi N, Tsutsumi R, Koizumi M, Yano T, Taketani Y. Increased risk of placenta previa is associated with endometriosis and tubal factor infertility in assisted reproductive technology pregnancy. Gynecol Endocrinol. 2013;29:113–5. Sazonova A, Kllen K, Thurin-Kjellberg A, Wennerholm U-B, Bergh C. Factors affecting obstetric outcome of singletons born after IVF. Hum Reprod. 2011;26:2878–86. Vercellini P, Parazzini F, Pietropaolo G, Cipriani S, Frattaruolo MP, Fedele L. Pregnancy outcome in women with peritoneal, ovarian and rectovaginal endometriosis: A retrospective cohort study. Br J Obstet Gynaecol. 2012;119:1538–43. Al-Sabbagh M, Lam EW-F, Brosens JJ. Mechanisms of endometrial progesterone resistance. Mol Cell Endocrinol. 2012;358:208–15. Petraglia F, Arcuri F, de Ziegler D, Chapron C. Inflammation: a link between endometriosis and preterm birth. Fertil Steril. 2012;98:36–40. Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu. 1972;1:177–91. Brosens I, Pijnenborg R, Benagiano G. Defective myometrial spiral artery remodelling as a cause of major obstetrical syndromes in endometriosis and adenomyosis. Placenta. 2013;34:100–5. King A, Hiby SE, Gardner L, Joseph S, Bowen JM, Verma S, et al. Recognition of trophoblast HLA class I molecules by decidual NK cell receptors e a review. Placenta. 2000;21(Suppl1):S81–5. Wallace AE, Fraser R, Cartwright JE. Extravillous trophoblast and decidual natural killer cells: a remodelling partnership. Hum Reprod Update. 2012;18:458–71. Maubon A, Faury A, Kapella M, Pouquet M, Piver P. Uterine junctional zone at magnetic resonance imaging: a predictor of in vitro fertilization implantation failure. J Obstet Gynaecol Res. 2010;36:611–8. Nakagawa K, Yamano S, Nakasaka H, Komatsu J, Hinokio K, Aono T. Effectiveness of pre-treatment with gonadotropin-releasing hormone agonist to the patients with endometriosis in in vitro fertilization and embryo transfer. Jpn J Fertil Steril. 2000;45:1–6. Mijatovic V, Florijn E, Halim N, Schats R, Hompes P. Adenomyosis has no adverse effects on IVF/ICSI outcomes in women with endometriosis treated with long-term pituitary down-regulation before IVF/ICSI. Eur J Obstet Gynecol Reprod Biol. 2010;151:62–5. Tremellen K, Russell P. Adenomyosis is a potential cause of recurrent implantation failure during IVF treatment. Aust N Z J Obstet Gynaecol. 2011;51:280–3. Thalluri V, Tremellen KP. Ultrasound diagnosed adenomyosis has a negative impact on successful implantation following GnRH antagonist IVF treatment. Hum Reprod. 2012;27:3487–92. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2014 Springer Japan About this chapter Cite this chapter Brosens, I., Benagiano, G. (2014). Pregnancy Complications Associated with Endometriosis. In: Harada, T. (eds) Endometriosis. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54421-0_28 Download citation DOI: https://doi.org/10.1007/978-4-431-54421-0_28 Published: Publisher Name: Springer, Tokyo Print ISBN: 978-4-431-54420-3 Online ISBN: 978-4-431-54421-0 eBook Packages: MedicineMedicine (R0)