Endometriosis infertility linked to higher pregnancy rates

Women with infertility linked to endometriosis are four times more likely to become pregnant than those with infertility from other causes, a 30-year study has found.

The findings analysed health records from more than four million women in England.

The data showed that 40.5 per cent of those diagnosed with endometriosis had at least one pregnancy during the study period.

Dr Lucky Saraswat, from the Aberdeen Centre of Women’s Health Research at the University of Aberdeen, who led the study, said: “Endometriosis can vary in how it affects fertility.

“Women with milder forms may retain good reproductive potential, especially if the condition is diagnosed and managed early.

“There’s also moderate-quality evidence suggesting that laparoscopic surgery can improve pregnancy rates in some with endometriosis.”

She added that women with endometriosis may be more likely to seek fertility help earlier due to greater awareness of the condition’s impact.

Researchers from the University of Aberdeen and the University of Edinburgh conducted the study as part of the EU-funded FEMaLe (Finding Endometriosis through Machine Learning) consortium.

It is the largest and longest population-based study of its kind, covering linked primary care, secondary care and maternity records between 1991 and 2020.

Of the 4,041,770 women aged 13 to 50 who attended primary care with infertility or symptoms of endometriosis, 111,197 had a surgically confirmed diagnosis of endometriosis via laparoscopy or laparotomy – procedures used to examine the abdomen and pelvic organs.

The overall prevalence of female infertility was 48.9 per 1,000 women, with the highest rates among those aged 30 to 39.

Among women with infertility, 6.1 per cent – 14,904 women – had surgically confirmed endometriosis.

Of these, 57.4 per cent had experienced infertility before their diagnosis, highlighting ongoing delays in recognising and diagnosing the condition.

The study reaffirmed that women with infertility were more than twice as likely to be diagnosed with endometriosis compared with those without infertility.

However, those with endometriosis-associated infertility had significantly higher pregnancy rates than women with infertility caused by ovulatory dysfunction, tubal factors or unexplained infertility.

Saraswat, said: “While fertility remains multifactorial, with factors such as age playing a significant role, our findings offer robust, evidence-based data that can significantly enhance fertility counselling for women newly diagnosed with endometriosis – including information on the likelihood of infertility, overall pregnancy rates and outcomes, and how those outcomes compare to other causes of infertility.

“These insights can empower women to make informed reproductive decisions.

“They also provide a strong foundation for future research into how factors such as disease stage, site, surgical treatment and use of assisted reproduction influence pregnancy outcomes in women with endometriosis.”

Professor Dr Anis Feki, chair-elect of ESHRE, said: “This study shows that women with endometriosis-related infertility are significantly more likely to conceive than those with other infertility causes.

“These findings provide valuable reassurance for patients and underscore the importance of early diagnosis and tailored treatment strategies.”