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From the Journals

Endometriosis Study Conceives New Fertility Insights

U.S. study of 51 million women reveals infertility triples endometriosis odds, spotlighting a reproductive health conundrum.

Conexiant

A recent cross-sectional study analyzing data from the National Survey of Family Growth (2011–2019) evaluated the prevalence and characteristics of women with endometriosis in the U.S. The study, published in the Journal of Endometriosis and Uterine Disorders, examined data from 17,619 women aged 20-44 years, representing a weighted sample of 51,981,323 U.S. women.

The national prevalence of endometriosis was 6.4%, with 7.37% of these women reporting infertility. Women with infertility had 3.61 times higher odds of having endometriosis compared to women without infertility (95% confidence interval [CI], 2.44–5.35). Notably, 53.94% of women with endometriosis were surgically sterile, with these women having 5.25 times higher odds of endometriosis (95% CI 3.66–7.54) compared to fecund women.

From 2017 to 2019, 67.50% of women with endometriosis reported experiencing pain-related functional impairment. Demographic analysis revealed that women diagnosed with endometriosis had an average age of 35.2 years, compared to 31.6 years for women without the condition.

The prevalence of endometriosis was highest among non-Hispanic White women (71.81%), while Black women had significantly lower odds (odds ratio [OR] 0.37, 95% CI, 0.22–0.62) and Hispanic women also had reduced odds (OR 0.45, 95% CI, 0.28–0.72). Women with uterine fibroids were 4.37 times more likely to have endometriosis (95% CI, 3.05–6.28).

Additional findings include:

  • Non-heterosexual women had 54% higher odds of endometriosis (95% CI 1.01–2.34) compared to heterosexual women.
  • Women covered by Medicare, military, or other governmental health insurance plans had 2.11 times higher odds of endometriosis (95% CI 1.04–4.28) compared to women with single-service, Indian service, or no insurance.
  • Women living in metropolitan areas had 29% lower odds of endometriosis (95% CI 0.52-0.97) compared to those in non-metropolitan areas.

No significant associations were found between endometriosis and socioeconomic factors such as poverty, education, or employment.

The study's limitations include its reliance on self-reported diagnosis of endometriosis, which may be subject to recall bias and potential misdiagnosis. Additionally, the cross-sectional design limits the ability to establish causal relationships.

Full disclosures can be found in the published study.