Fertility experiences in women reporting endometriosis: findings from the Understanding Fertility Management in Contemporary Australia survey

Purpose: To examine the fertility experiences of women reporting and not reporting endometriosis in a population-based survey. Materials and methods: A cross-sectional survey among a community sample of 1543 women in Australia. Data were analysed to compare fertility management between women who did and did not report endometriosis. Factors associated with unintended pregnancy, infertility diagnosis, time to conception and live birth were identified through multivariable analyses. Results: While individual contraceptive use did not differ by endometriosis status, avoiding pregnancy was less important to women reporting endometriosis (50.5%) than to others (68.7%; p <.001). Women reporting endometriosis were approximately three times more likely to report an infertility diagnosis—the majority (39.7%) of which were ‘unexplained female or male infertility’—(p <.001) and six times more likely to report taking longer than 12 months to conceive than those who did not report endometriosis (p <.001). Although more women reporting a diagnosis of endometriosis also reported never having been pregnant (11.9%) than those who did not report a diagnosis (6.0%), this difference was not statistically significant (p =.060). There were also no endometriosis-associated differences in women’s reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth. Conclusions: Our findings counter the common assertion that women with endometriosis are unlikely to conceive, and support the need for health care and information that addresses all aspects of fertility management (not just infertility) for women with endometriosis.