Reproductive
Endometriosis Typology and Infertility Rachel Myrer* Rachel Myrer Myrer Myrer Myrer Myrer Myrer Myrer Myrer Westminster University
Background: Endometriosis affects approximately 11% of women of reproductive age and is a significant cause of female factor infertility. Current classification systems inadequately predict infertility diagnoses, highlighting the need for improved classification approaches. Objective: The main objective is to evaluate the relationship between endometriosis subtypes and infertility risk using a large population-based cohort. Methods: We used a retrospective cohort from the Utah Population Database (1996–2020) including 461,684 women, with 79,600 diagnosed with endometriosis. Endometriosis subtypes were classified as superficial endometriosis (SE), ovarian endometriomas (OE), deep infiltrating endometriosis (DE), and other endometriosis. The primary analysis used Cox proportional hazards models to assess the hazard ratio of infertility diagnosis across endometriosis subtypes. Results: Women with endometriosis had a significantly higher risk of infertility compared to women without endometriosis (adjusted Hazard Ratio [aHR] 6.07, 95% CI 5.77-6.40). Infertility risk differed by endometriosis subtype, with the highest risk among those with deep infiltrating disease and/or ovarian endometriomas (aHR 9.01; 95% CI: 8.45–9.60), followed by other endometriosis (aHR 5.35; 95% CI: 4.94–5.79) and superficial endometriosis (aHR 4.36; 95% CI: 4.04–4.71). Conclusion: Endometriosis subtypes demonstrate different infertility risks, with deep infiltrating and ovarian endometriomas associated with the highest risk. These findings suggest the importance of considering endometriosis typology in clinical practice and research, potentially offering a more nuanced approach to patient care and fertility management.