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Endometriosis and spontaneous abortion rate: a cohort study in infertile women
R Matorras1, F Rodríguez, G Gutierrez de Terán
1Department of Obstetrics and Gynecology, Hospital of Cruces-Baracaldo, País Vasco University, Vizcaya, Spain.
Objective:
To ascertain if there is an association between endometriosis and spontaneous abortion.
Design:
Prospective cohort study.
Setting:
Medical School Hospital.
Population:
174 infertile women laparoscopically diagnosed with endometriosis and 174 infertile women in which endometriosis was ruled out by laparoscopy, in the same period of time.
Main Outcome Measure:
Spontaneous abortion. Non-progressive gestational sac and/or histological study.
Results:
Per woman abortion rate was 7.47% (13/174) in the endometriosis group, similar to 5.74% (10/174) in the infertile women without endometriosis (RR=1.32: CI=0.53-3.36). Nor were there any differences in the per pregnancy abortion rate: 20.96% (13/62) in endometriosis vs. 16.94% (10/59) in non-endometriosis (RR=1.3; CI=0.47-3.57). The abortion rate was similar in the different AFS stages: 22.86% (8/35) in stage I, 16.67% (3/18) in II, 25% (1/4) in III and 20% (1/5) in IV. In stage I no differences were observed in patients who were managed expectantly or with medical treatment.
Conclusion:
Endometriosis is not associated with an increased abortion rate. The severity of disease expressed by AFS staging is not associated with an increase in the abortion rate. In stage I the treatment of endometriosis did not decrease abortion rates.