New research from the Royal Women’s Hospital shows that over half of women who had surgery for an ectopic pregnancy also had hidden endometriosis.
The study published in the Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) examined 65 women who had surgery for tubal ectopic pregnancy. It found that 55% had endometriosis … most without knowing it.
Dr Jennifer Dean led the research with her colleagues from the Department of Gynaecology at the Women's: Dr Stephen Lee, Dr Claudia Cheng, Dr Charlotte Reddington, Dr Michal Amir and Associate Professor Martin Healey.
“Even a low grade of endometriosis seems to link with ectopic pregnancy,” said Dr Dean.
“We think the inflammation caused by endometriosis affects the fallopian tubes and raises the risk.”
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. It can cause pain and fertility problems but often goes undiagnosed.
In this study, most women with endometriosis had a mild form of the condition and no idea they had it.
“The vast majority were unaware,” said Dr Dean. “It’s hard to diagnose based on symptoms alone.”
Right now, as part of every laparoscopy, doctors should be assessing for evidence of endometriosis as routine, Dr Dean says: “It’s part of a good diagnostic laparoscopy, and now we have strong evidence to support it.”
The findings may also change how fertility is managed after an ectopic pregnancy. Many women with mild endometriosis can conceive naturally. However, getting a diagnosis can help them make choices about future pregnancies.
“Having that information in your back pocket is powerful,” said Dr Dean. “
If you’re struggling to fall pregnant, it can help you make informed decisions about your future fertility plans.”
The team hopes to do more research, including whether treating endometriosis during ectopic pregnancy surgery might improve outcomes.
“There’s huge scope for future work,” said Dr Dean. “This study gives us a strong basis to build on.”
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