THE IMPACT OF ENDOMETRIOSIS IN WOMEN WITH INFERTILITY PROBLEMS

THE IMPACT OF ENDOMETRIOSIS IN WOMEN WITH INFERTILITY PROBLEMS

DID YOU KNOW that Endometriosis affects an estimated 1 in 10 women, girls, and gender diverse individuals around the world ?
Up to 30% to 50% of women with endometriosis may experience infertility.

DID YOU KNOW?

Endometriosis is now being recognized as one of the most potentially excruciating & destructive medical conditions on record, which affects an estimated 1 in 10 women around the world. That´s about as prevalent as diabetes in women and works out to approximately 200 million worldwide. Among women with minimal/mild endometriosis, approximately 50% will be able to conceive without treatment, whereas in women with moderate disease, only 25% will conceive spontaneously, and few spontaneous conceptions occur in the case of severe disease(1). Although many theories exist as to the development of endometriosis, the most generally accepted one is that it may be initiated by retrograde menstrual flux through the Fallopian tubes. Epithelial progenitor cells derived from the shedding of endometrial tissue can implant on the peritoneum, ovaries, or in the rectovaginal pouch. Once established, these hormone-responsive and cyclically active endometriotic lesions drive acute then chronic inflammatory reactions, and lead to pelvic adhesions, pain, and infertility. Individual susceptibility to endometriosis, however, is influenced by genetic, anatomical, endocrine, and environmental factors (1).

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New horizons in infertility management – Use of contrast medium in HSG?

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ENDOMETRIOSIS – CLINICAL DATA

When endometriosis is the barrier for fertility.

M. Rudnicki et al.
PMID : 28556123

The FLUSH trial - flushing with lipiodol for unexplained (and endometriosis-related) subfertility by hysterosalpingography : a randomized trial.

Johnson NP et al.
Hum Reprod. 2004 Sep;19(9):2043-51.

After the FLUSH trial: A prospective observational study of lipiodol flushing as an innovative treatment for unexplained and endometriosis-related infertility.

Brent K et al.
Aust N Z J Obstet Gynaecol. 2006 Aug;46(4):293-7.

Lipiodol fertility enhancement: two-year follow-up of a randomized trial suggests a transient benefit in endometriosis, but a sustained benefit in unexplained infertility.

Johnson NP et al.
Hum Reprod. 2007 Nov;22(11):2857-62.

The Lipiodol Uterine Bathing Effect to Improve Fertility May Include Uterine Natural Killer Cell Up-regulation in the Endometrium, Fertility & Reproduction.

Johnson et al.
Vol. 03, No. 01, pp. 10-13 (2021).

Safety of oil-based contrast medium for hysterosalpingography: a systematic review.

Roest I et al.
Elsevier Ltd on behalf of Reproductive Healthcare Ltd., 2021.

The IVF-LUBE trial – a randomized trial to assess Lipiodol® uterine bathing effect in women with endometriosis or repeat implantation failure undergoing IVF.

Brent K et alReilly et al.
Reprod 2019 March; 38(3):380-386.

References

1. Tanbo T, FedorcsakP. Endometriosis-associated infertility: aspectsof pathophysiological mechanisms andtreatment options. Acta Obstet GynecolScand 2017; 96:659–667.