ABSTRACT
A possible association between endometriosis and spontaneous abortion has been suggested
in mostly uncontrolled and/or retrospective studies. Some controlled studies evaluating
the association between endometriosis and spontaneous abortion showed important methodological
shortcomings: heterogeneity between cases and controls, analysis of the abortion rate
before the diagnosis of endometriosis, and selection bias of study and control groups.
On the basis of controlled prospective studies, there is no evidence that endometriosis
is associated with (recurrent) pregnancy loss or that medical or surgical treatment
of endometriosis reduces the spontaneous abortion rate. In programs of assisted reproduction,
some studies have shown that the number and quality of oocytes, the fertilization
rate, and the implantation rate per embryo may be reduced in women with endometriosis,
but this observation has not been confirmed by other investigators. Future studies
evaluating the reproductive outcome of patients with endometriosis in assisted reproduction
programs should include reliable information about the date and histological confirmation
of the diagnosis of endometriosis, time interval between treatment with assisted reproduction
and the last laparoscopy, possible recurrence of endometriosis, effectiveness of interim
hormonal (suppressive) therapy, accuracy of ultrasound diagnosis, and accuracy of
``negative'' diagnosis.
KEYWORD
Endometriosis - abortion - recurrent pregnancy loss
