Effect of oral contraceptive use in relation to fertile years on the risk of endometriosis in women with primary infertility

Vesna Šalamun; Gaetano Riemma; Anja Klemenčič; Antonio Simone Laganà; Pasquale De Franciscis; Martin Štimpfel; Sara Korošec; Helena Ban Frangež

Effect of oral contraceptive use in relation to fertile years on the risk of endometriosis in women with primary infertility

Vesna Šalamun, Gaetano Riemma, Anja Klemenčič, Antonio Simone Laganà, Pasquale De Franciscis, Martin Štimpfel, Sara Korošec, Helena Ban Frangež

In: ISSN: 1648-9144 · 2026 · W7164871689

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⚙ AI-generated summary by claude@2026-07, 2026-07-09 ⓘ

This study investigated the association between oral contraceptive use during fertile years and the risk of endometriosis in women experiencing primary infertility.

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This monocentric retrospective cohort study (2012–2022) investigated whether prior oral contraceptive (OC) use is associated with the likelihood of discovering histopathologically confirmed endometriosis among reproductive-aged women undergoing laparoscopy for primary infertility, comparing 390 cases with endometriosis to 1533 controls without it. Women were categorized by the ratio of years of OC use to fertile years (never, 50), and OC exposure was analyzed against overall endometriosis diagnosis and rASRM stage and lesion subtypes. Although prior OC use was more common in women with endometriosis than controls (72.31% vs 58.64%), overall OC use was not associated with endometriosis diagnosis (aOR 1.06, 95% CI 0.87–1.29), and no clear increased risk was seen for superficial endometriosis, endometriomas, or deep infiltrating endometriosis. The authors report a possible protective association when OCs were used for <25% of fertile age for rASRM stage III endometriosis and superficial implants, and they emphasize that prospective studies are needed due to study limitations. This paper is centrally about endometriosis — specifically, the relationship between oral contraceptive use timing and histopathological discovery and staging of endometriosis in women with primary infertility.

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Abstract

Background and Objectives: Oral contraceptives (OCs) are usually used to treat endometriosis

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| Naslov: | Effect of oral contraceptive use in relation to fertile years on the risk of endometriosis in women with primary infertility : a ten-year single-centre retrospective analysis | |---| | Avtorji: | ID Šalamun, Vesna (Avtor) ID Riemma, Gaetano (Avtor) ID Klemenčič, Anja (Avtor) ID Laganà, Antonio Simone (Avtor) ID De Franciscis, Pasquale (Avtor) ID Štimpfel, Martin (Avtor) ID Korošec, Sara (Avtor) ID Ban Frangež, Helena (Avtor) | | Datoteke: | PDF - Predstavitvena datoteka, prenos (1,05 MB) MD5: 805155AFA45D071F48726D2CAA0FD733 URL - Izvorni URL, za dostop obiščite https://www.mdpi.com/1648-9144/60/6/959 | |---| | Jezik: | Angleški jezik | |---| | Tipologija: | 1.01 - Izvirni znanstveni članek | |---| | Organizacija: | UKC LJ - Univerzitetni klinični center Ljubljana | |---| | Povzetek: | Background and Objectives: Oral contraceptives (OCs) are usually used to treat endometriosis; however, the evidence is inconsistent about whether OC use in the past, when given to asymptomatic women, is protective against the development of future disease. We aimed to assess the relationship between the use of OCs and the likelihood of discovering endometriosis, considering the length of time under OCs during their fertile age. Materials and Methods: This was a monocentric retrospective cohort study in a tertiary-care University Hospital (Department of Human Reproduction, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Slovenia) carried out from January 2012 to December 2022. Reproductive-aged women scheduled for laparoscopic surgery for primary infertility and subsequent histopathological diagnosis of endometriosis were compared to women without an endometriosis diagnosis. They were classified based on the ratio of years of OC use to fertile years in four subgroups: never, 50. Results: In total, 1923 women (390 with and 1533 without endometriosis) were included. Previous OC use was higher in those with endometriosis than controls (72.31% vs. 58.64%; p = 0.001). Overall, previous OC usage was not related to histopathological diagnosis of endometriosis (aOR 1.06 [95% CI 0.87–1.29]). Women who used OCs for less than 25% of their fertile age had reduced risk of rASRM stage III endometriosis (aOR 0.50 [95% CI 0.26–0.95]; p = 0.036) or superficial implants (aOR 0.88 [95% CI 0.58–0.95]; p = 0.040). No significant results were retrieved for other rASRM stages. Using OCs for 50% of fertile age did not increase the risk of developing superficial endometriosis, endometriomas, or DIE. Conclusions: When OCs are used at least once, histological diagnoses of endometriosis are not increased. A protective effect of OCs when used for less than 25% of fertile age on superficial implants may be present. Prospective research is needed to corroborate the findings due to constraints related to the study’s limitations | |---| | Ključne besede: | endometriosis, oral contraceptives, staging, endometrioma, deep infiltrating endometriosis, infertility | |---| | Status publikacije: | Objavljeno | |---| | Verzija publikacije: | Objavljena publikacija | |---| | Leto izida: | 2024 | |---| | Št. strani: | Str. 1-9 | |---| | Številčenje: | [iss.] 6, Vol. 60 | |---| | PID: | 20.500.12556/DiRROS-30050 | |---| | UDK: | 61 | |---| | ISSN pri članku: | 1648-9144 | |---| | DOI: | 10.3390/medicina60060959 | |---| | COBISS.SI-ID: | 199138051 | |---| | Opomba: | Nasl. z nasl. zaslona; Opis vira z dne 17. 6. 2024; | |---| | Datum objave v DiRROS: | 12.06.2026 | |---| | Število ogledov: | 162 | |---| | Število prenosov: | 114 | |---| | Metapodatki: | | |---| | : | Kopiraj citat | |---| | | | | Objavi na: | | |---| Postavite miškin kazalec na naslov za izpis povzetka. Klik na naslov izpiše podrobnosti ali sproži prenos. |

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