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    Is endometriosis as tied to infertility as we think?

    The risk of infertility associated with endometriosis may not be nearly as high as previously thought, according to results of a new study published in Human Reproduction.

    Researchers at Brigham and Women’s Hospital looked at data collected from 58,427 premenopausal, married female nurses aged <40 years, from 1989 to 2005. The women were participants in the Nurses’ Health Study II prospective cohort. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated via multivariate Cox proportional hazards regression models.

    Related: The case for surgery for endometriosis

    In the cohort, they found 4612 incident cases of infertility due to any cause over the course of 362,219 person-years of follow up. When compared to women with no history of endometriosis, those with a history of the condition had an age-adjusted 2-fold increased risk of incident infertility (HR = 2.12, 95% CI = 1.76–2.56). This was attenuated after taking into account parity. A relationship between endometriosis and infertility was only seen among women aged < 35 years (multivariate HR <35 years = 1.77, 95% CI = 1.46–2.14; multivariate HR 35–39 years = 1.20, 95% CI = 0.94–1.53; P-interaction = 0.008). The risk of primary versus secondary infertility was similar following endometriosis diagnosis.

    Among women who had primary infertility, 50% became parous after being diagnosed with endometriosis. Among all women with endometriosis, 83% were parous by age 40 years.

    The investigators concluded that their results support a temporal link between infertility risk and endometriosis. They believe that the results also indicated a possible detection bias in previous studies examining endometriosis and infertility. They also concluded that the risk of infertility posed by endometriosis may be half what was seen in earlier cross-sectional analyses.

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    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

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