Untreated endometriosis linked to higher miscarriage rates
A 1984 retrospective case series from one private practice compared three groups of women with endometriosis. In this series, just over 5 out of 10 women with untreated endometriosis miscarried. Among women who conceived after surgery, just over 1 out of 10 did. After danazol, fewer than 1 out of 10 did.
About 5 in 10 women with untreated endometriosis miscarried. Source: Groll M, 1984, PMID 6427022.Study at a glance, retrospective case series of 27 untreated patients: Untreated endometriosis linked to higher miscarriage rates. Source: Groll M, 1984, PMID 6427022.
Key Findings
Of 27 untreated patients, 14 had spontaneous abortions (52%). The rate showed no statistically significant difference by severity of endometriosis.
Of 25 women who conceived after conservative surgery, 3 had spontaneous abortions (12%). Of 28 who conceived after danazol, 2 did (7%).
Either treated group differed from the untreated group at the 0.01 level of statistical significance. The two treated groups showed no statistical difference in abortion rate.
In untreated women, 11 of 12 pregnancies (92%) aborted when the pregnancy came less than 2 years before diagnosis. None of 6 pregnancies 6 or more years before diagnosis aborted.
Luteal phase deficiency was diagnosed in 17 of 27 untreated women (62%), 11 of 25 surgically treated (44%) and 17 of 28 danazol-treated (61%), with no statistical difference among the three groups.
Interpretation
This 1984 retrospective case series examined women with endometriosis in one private practice, following three groups: untreated, treated with surgery, and treated with danazol. Miscarriage was linked with treatment, and was far more common in the untreated group than in either treated group. The author lists luteal dysfunction, autoimmunity and prostaglandins as possible reasons. The findings support larger, controlled studies of how treating endometriosis affects pregnancy loss.
RRM Context
Restorative reproductive medicine treats endometriosis as a cause of pregnancy loss. Two earlier reports cited here also linked endometriosis to more miscarriages in the first trimester. Luteal phase deficiency was found in 62% of the untreated women here. RRM evaluation looks for causes like this.
Our editorial summary of this paper, not the article's abstract.
Abstract
There seems to be an association of first-trimester spontaneous abortion and untreated endometriosis. In this report, 52% of an untreated group of patients with endometriosis aborted. However, 12% of a second group of surgically treated patients and 7% of a third group of patients treated with danazol aborted. Therefore, either medical or surgical therapy for endometriosis lowers the abortion rate significantly.
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