Incidence Rate of First Live Birth Lower for Women With Endometriosis

WEDNESDAY, July 5, 2023 (HealthDay News) -- Women with a subsequent surgical diagnosis of endometriosis have a significantly lower incidence of first live birth and lower fertility rate, according to a study published online July 4 in Human Reproduction.

Ada Tuominen, from Helsinki University Hospital and the University of Helsinki, and colleagues conducted a retrospective population-based cohort study involving women with surgical verification of endometriosis in 1998 to 2012. The final cohort included 18,324 women with endometriosis (6,384 with isolated diagnosis of ovarian; 5,789 with peritoneal; 1,267 with deep endometriosis) and 35,793 matched reference women. The incidence rate (IR) and incidence rate ratio (IRR) of first live birth before surgical verification of endometriosis were calculated.

Overall, 40.2 and 66.3 percent of women with and without endometriosis, respectively, delivered a live born infant before the index day (surgery). The researchers found that the IRs of the first live birth per 100 person-years were 2.64 and 5.21 in the endometriosis and reference cohorts, respectively. The IRs were similar between the endometriosis sub-cohorts. For first live birth, the IRR was 0.51 between the endometriosis and reference cohorts; IRRs did not differ between the endometriosis subcohorts. Per parous woman, the fertility rate before surgical diagnosis was 1.93 and 2.16 in the endometriosis and reference cohorts, respectively. The median age at first live birth was 25.5 years for both women with endometriosis and reference cohorts; surgical diagnosis of endometriosis occurred at a median age of 35.0 years.

"Endometriosis seems to affect parity years before its eventual diagnosis," the authors write. "The impairment of fertility among women with endometriosis should be minimized by offering relevant treatment for endometriosis without delay."

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