The study “Pregnancy outcome in women with endometriosis achieving pregnancy with IVF,” published in the Human Reproduction journal, reports a retrospective matched case–control study of women successful with in vitro fertilization (IVF) pregnancy. The authors aimed to better understand the implications of endometriosis in the risk of developing pregnancy-associated complications and premature birth incidence.
The inner tissue of the uterus – endometrium – is very important for fertilized egg implantation and normal pregnancy. Indeed, some infertility cases are due to alterations on the endometrium. In cases of endometriosis, the endometrium grows abnormally into the outside of the womb.
For the study, 239 women diagnosed with endometriosis and 239 age-matched controls with no record of endometrium alterations were studied. All of them underwent successful IVF.
The authors report that they could not find any differences between the study groups and controls concerning incidents of live birth, hypertensive disorders, gestational diabetes, small or large for gestational age nor newborn problems. Additionally, the study could not identify any differences between the groups in frequency of premature births.
However, study authors reported that women with endometriosis have 4.8 times more risk of placenta previa. Placenta previa describes the abnormal position of the placenta too close or on top of the cervix – whcih can cause natural birth complications. Six percent of the women with endometriosis in the endometriosis group had placenta previa compared to one percent in the control group.
In summary, women with diagnosed endometriosis who undergo IVF pregnancies do not seem to represent a group at risk for major complications, with the exception of placenta previa.
Nevertheless, the authors highlight that the results are only valid for IVF pregnancies and that more studies should be conducted with bigger cohorts and that the association with placenta privia might open new research paths.