Somigliana Edgardo, Facchin Federica, Busnelli Andrea, Benaglia Laura, Biancardi Rossella, Catavorello Anita, Vercellini Paolo
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via M. Fanti, 6, 20122, Milan, Italy.
Obstet-Gynecol Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Reprod Sci. 2020 Jan;27(1):389-394. doi: 10.1007/s43032-019-00068-7. Epub 2020 Jan 1.
Several pathogenetic mechanisms have been postulated to explain the association between endometriosis and subfertility. However, to date, definitive conclusions cannot be drawn. In this study, we hypothesized that the reduced exploitation of the natural chances of conception could be an additional detrimental factor. Due to dyspareunia or the need for hormonal treatment to temper pelvic pain, one may expect affected women to exploit less the chances of natural pregnancy. In this cross-sectional study of 292 women undergoing IVF, we investigated the severity of pelvic pain symptoms, the sexual function (using the Female Sexual Function Index [FSFI]), and the reproductive strategies of women with (n = 62) and without (n = 230) endometriosis. Basal clinical and demographic characteristics did not differ between the two groups. Conversely, all pelvic pain symptom scores were increased in women with endometriosis. Endometriosis patients also showed greater pain at the FSFI, but no other significant differences were detected as regards sexual function. The use of hormonal contraceptive agents did not differ between the study groups. Moreover, questions aimed at disentangle whether affected women exploited less the natural chances of pregnancy did not reveal any significant difference. In conclusion, this study does not support the hypothesis that women with endometriosis exploit less the chances of natural pregnancy, despite the presence of pelvic pain.
人们已经提出了几种致病机制来解释子宫内膜异位症与生育力低下之间的关联。然而，迄今为止，仍无法得出明确的结论。在本研究中，我们假设自然受孕机会的利用减少可能是另一个有害因素。由于性交困难或需要激素治疗来缓解盆腔疼痛，人们可能会预期受影响的女性利用自然怀孕机会的情况较少。在这项对292名接受体外受精的女性进行的横断面研究中，我们调查了有（n = 62）和没有（n = 230）子宫内膜异位症的女性的盆腔疼痛症状严重程度、性功能（使用女性性功能指数[FSFI]）以及生殖策略。两组之间的基础临床和人口统计学特征没有差异。相反，子宫内膜异位症女性的所有盆腔疼痛症状评分均升高。子宫内膜异位症患者在FSFI上也表现出更大的疼痛，但在性功能方面未检测到其他显著差异。研究组之间激素避孕药的使用情况没有差异。此外，旨在弄清楚受影响女性是否较少利用自然怀孕机会的问题并未显示出任何显著差异。总之，本研究不支持子宫内膜异位症女性尽管存在盆腔疼痛但利用自然怀孕机会较少这一假设。
