Natural Pregnancy Seeking in Subfertile Women with Endometriosis

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This study investigated pelvic pain, sexual function, and reproductive strategies in women with and without endometriosis, finding no difference in natural pregnancy exploitation despite increased pain in endometriosis patients.

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This cross-sectional study enrolled 292 women undergoing IVF, comparing 62 with endometriosis to 230 without, and assessed pelvic pain severity, sexual function (Female Sexual Function Index, FSFI), and reproductive strategies related to pursuing natural pregnancy chances. Women with endometriosis had higher pelvic pain symptom scores and reported greater pain on the FSFI, but showed no other significant differences in sexual function, and hormonal contraceptive use did not differ between groups. Using questionnaire items to test whether women with endometriosis exploit natural conception chances less did not reveal significant differences. The study’s limitation is its cross-sectional design, which cannot establish causality behind the hypothesized reduced natural pregnancy seeking. This paper is centrally about endometriosis — it evaluates whether subfertile women with endometriosis pursue natural pregnancy chances differently during fertility care.

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Abstract

Several pathogenetic mechanisms have been postulated to explain the association between endometriosis and subfertility. However, to date, definitive conclusions cannot be drawn. In this study, we hypothesized that the reduced exploitation of the natural chances of conception could be an additional detrimental factor. Due to dyspareunia or the need for hormonal treatment to temper pelvic pain, one may expect affected women to exploit less the chances of natural pregnancy. In this cross-sectional study of 292 women undergoing IVF, we investigated the severity of pelvic pain symptoms, the sexual function (using the Female Sexual Function Index [FSFI]), and the reproductive strategies of women with (n = 62) and without (n = 230) endometriosis. Basal clinical and demographic characteristics did not differ between the two groups. Conversely, all pelvic pain symptom scores were increased in women with endometriosis. Endometriosis patients also showed greater pain at the FSFI, but no other significant differences were detected as regards sexual function. The use of hormonal contraceptive agents did not differ between the study groups. Moreover, questions aimed at disentangle whether affected women exploited less the natural chances of pregnancy did not reveal any significant difference. In conclusion, this study does not support the hypothesis that women with endometriosis exploit less the chances of natural pregnancy, despite the presence of pelvic pain.
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Abstract

Several pathogenetic mechanisms have been postulated to explain the association between endometriosis and subfertility. However, to date, definitive conclusions cannot be drawn. In this study, we hypothesized that the reduced exploitation of the natural chances of conception could be an additional detrimental factor. Due to dyspareunia or the need for hormonal treatment to temper pelvic pain, one may expect affected women to exploit less the chances of natural pregnancy. In this cross-sectional study of 292 women undergoing IVF, we investigated the severity of pelvic pain symptoms, the sexual function (using the Female Sexual Function Index [FSFI]), and the reproductive strategies of women with (n = 62) and without (n = 230) endometriosis. Basal clinical and demographic characteristics did not differ between the two groups. Conversely, all pelvic pain symptom scores were increased in women with endometriosis. Endometriosis patients also showed greater pain at the FSFI, but no other significant differences were detected as regards sexual function. The use of hormonal contraceptive agents did not differ between the study groups. Moreover, questions aimed at disentangle whether affected women exploited less the natural chances of pregnancy did not reveal any significant difference. In conclusion, this study does not support the hypothesis that women with endometriosis exploit less the chances of natural pregnancy, despite the presence of pelvic pain. Similar content being viewed by others

References

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Natural Pregnancy Seeking in Subfertile Women with Endometriosis. Reprod. Sci. 27, 389–394 (2020). https://doi.org/10.1007/s43032-019-00068-7 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-019-00068-7

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Infertility, Female Pelvic Pain Adult Cross-Sectional Studies Endometriosis Endometriosis Female Fertilization in Vitro Humans Infertility, Female Infertility, Female Pelvic Pain Pelvic Pain Pregnancy Surveys and Questionnaires

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