YORK, Pa. — One in 10 women live with endometriosis. The often painful and debilitating disease has also been linked to pregnancy and childbirth complications. A team of doctors in Italy say they may have some ways to change that.
Endometriosis occurs when endometrium tissue grows outside of the uterus, often in the fallopian tubes, ovaries, appendix, bowel or diaphragm. It can lead to irritable bowel syndrome, chronic pain in the pelvis and lower abdomen, and an increased risk of infertility.
Dr. Gerald Harkins from Penn State Hershey's Center for Endometriosis and Female Pelvic Pain says why, though, is not well documented. "It is a disease of inflammation and inflammation can have negative impacts on implantation and fertility. But whether it’s the endometriosis adhesions themselves, or the local environment within the uterus that causes problems, is still not clear," he said.
The new report in the Journal of Maternal-Fetal & Neonatal Medicine offered a few ways to improve pregnancy prognosis- including surgery to remove any endo adhesions. "We definitely know that studies have shown if you have surgery for the endometriosis, resect the endometriosis, flush the uterus and fallopian tubes, that woman will have improved fertility for some 6-8 months after surgery," Dr. Harkins said.
The report also suggests that all patients start taking 400 micrograms on folic acid and patients with advanced stages of endo should undergo hormone therapy, in vitro fertilization and an embryo transfer.
Regardless of the study, Dr. Harkins says the best way forward is for there to be a registry created to follow patients prospectively. "Every patient gets put on a registry, every patient then has their course at least documented at different times, and then their outcomes documented. If we do a thousand surgeries a year, tracking each of those patients at 6 months or a year out is difficult, but it is something that we, it's the goal we should be looking for," Harkins announced.
And he thinks the best possible way to do that is to get more people involved.
"If we see 800-1000 patients at Penn State Hershey, if we involved University of Pennsylvania, Columbia in New York, Brigham and Women's, now all of a sudden we have a cohort of 5,000 patients and having a cohort of 5000 or 6000 patients is a much stronger study if you follow it over time," he said.
For more information about the Center for Endometriosis and Female Pelvic pain, click here.
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