Fertility experiences in women reporting endometriosis: findings from the Understanding Fertility Management in Contemporary Australia survey

Abstract

Purpose: To examine the fertility experiences of women reporting and not reporting endometriosis in a population-based survey.

Materials and methods: A cross-sectional survey among a community sample of 1543 women in Australia. Data were analysed to compare fertility management between women who did and did not report endometriosis. Factors associated with unintended pregnancy, infertility diagnosis, time to conception and live birth were identified through multivariable analyses.

Results: While individual contraceptive use did not differ by endometriosis status, avoiding pregnancy was less important to women reporting endometriosis (50.5%) than to others (68.7%; p < .001). Women reporting endometriosis were approximately three times more likely to report an infertility diagnosis—the majority (39.7%) of which were ‘unexplained female or male infertility’—(p < .001) and six times more likely to report taking longer than 12 months to conceive than those who did not report endometriosis (p < .001). Although more women reporting a diagnosis of endometriosis also reported never having been pregnant (11.9%) than those who did not report a diagnosis (6.0%), this difference was not statistically significant (p = .060). There were also no endometriosis-associated differences in women’s reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth.

Conclusions: Our findings counter the common assertion that women with endometriosis are unlikely to conceive, and support the need for health care and information that addresses all aspects of fertility management (not just infertility) for women with endometriosis.

摘要

目的：在一项基于人群的调查中, 研究报告和未报告子宫内膜异位症妇女的生育经验。

材料和方法：对澳大利亚 1543 名妇女的社区样本进行横断面调查。对数据进行分析以比较有子宫内膜异位症和无子宫内膜异位症妇女的生育管理。通过多变量分析确定意外妊娠、不孕诊断、受孕时间和活产相关的因素。

结果：虽然个体避孕措施的使用没有因子宫内膜异位症的状态而不同, 但对报告子宫内膜异位症的妇女 (50.5%) 而言, 避免怀孕的重要性低于其他妇女 (68.7%；p < 0.001)。报告子宫内膜异位症的妇女被诊断为不孕症的可能性大约是未报告子宫内膜异位症妇女的3倍, 其中大多数的 (39.7%) 不孕症患者为“不明原因的女性或男性不育症” (P < 0.001), 而报告子宫内膜异位症的妇女出现受孕时间超过12个月的情况是未报告子宫内膜异位症妇女的6倍 (P < 0.001)。尽管报告诊断为子宫内膜异位症的妇女中, 从未怀孕的妇女 (11.9%) 多于未报告诊断的妇女 (6.0%), 但这一差异无统计学意义 (P = 0.060)。妇女意外怀孕、流产、怀孕或活产的报告也没有与子宫内膜异位症相关的差异。

结论：我们的研究结果反驳了子宫内膜异位症妇女不太可能怀孕的普遍观点, 并支持对子宫内膜异位症妇女进行全方位生育管理(不仅仅是不孕)的卫生保健和信息的需求。

Keywords:

• Endometriosis
• fertility
• infertility
• unintended pregnancy
• abortion
• surveys and questionnaires

Acknowledgments

The authors thank all respondents for their generous participation. We also acknowledge the original collaborators of the larger study: Lynne Jordan, Kathy McNamee, Chris Bayly, John McBain, and Vikki Sinnott. We are grateful also to Dr. Thach Tran for statistical advice.

Disclosure statement

No potential conflict of interests was reported by the authors.

Additional information

Funding

The study was funded by the Australian Research Council (LP100200432) in partnership with Family Planning Victoria, Melbourne IVF, The Royal Women’s Hospital and the Victorian Government Department of Health. KY receives a stipend scholarship from the National Health and Medical Research Council and Australian Rotary Health. JF is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship which receives funding from the L and H Hecht Trust, managed by Perpetual Trustees Pty Ltd.