The undiagnosed condition wasting valuable time in fertility treatment

UQ researcher Katrina Moss hopes her latest research showing women with undiagnosed endometriosis have poorer fertility treatment outcomes will help them avoid wasting valuable time and money.

Dr Moss, from UQ’s School of Public Health, led a study looking at more than 1300 women who had undergone fertility treatments.

UQ researcher Dr Katrina Moss wanted to find out whether the timing of an endometriosis diagnosis made a difference to successful fertility treatment.

The research discovered about 35 per cent of the women had endometriosis, and a third of those were not diagnosed when they started their treatments.

Endometriosis is a disorder in which tissue that normally grows inside the uterus grows elsewhere in the abdomen, often causing discomfort and pain, as well as fertility issues.

An estimated one in nine Australian women have the condition, but it can be hard to diagnose and has historically been under-diagnosed, with a confirmed diagnosis taking anywhere between four and 11 years.

“Because endometriosis can take so long to diagnose, we wanted to find out whether the timing of a diagnosis made a difference [to successful fertility treatment], and it turns out it did,” Dr Moss said.

“For women who already knew they had endo when they started fertility treatment, the outcomes were pretty much the same as for women without endometriosis, so their knowledge of diagnosis levelled the playing field for them.”

By contrast, undiagnosed women were four times more likely to undergo a lot of cycles of fertility treatment â€" sometimes as many as 36 â€" and were also 33 per cent less likely to conceive, the study found.

It is usually recommended that women with endometriosis go straight to in-vitro fertilisation (IVF), where an embryo is grown and implanted in the womb directly, as opposed to intrauterine insemination (IUI), where their partner’s semen is injected directly into the uterus.

IUI is less invasive and painful but has been shown to be less effective in women with underlying conditions, including endometriosis.

Dr Moss knows firsthand the pain and frustration of going through fertility treatment with the condition, having gone through the process herself.

Already diagnosed with endometriosis, she skipped IUI and went straight to IVF. Unfortunately, after 12 cycles she and her partner were still unable to conceive.

“We were one of the majority of couples who walk away from IVF without a baby, which was the most difficult thing I’ve ever done,” she said.

“But even though it didn’t work for us, I’m glad we didn’t waste time and money on IUI.”

She said women who went through fertility processes with undiagnosed endometriosis were potentially wasting valuable time.

“It takes time to cycle through IUI and progress to IVF, and age is one of the key determinants of success in fertility treatment,” she said.

“For some women, it was a period of years. Some did their treatments all at once, and some spaced them out because they’re really hard, but all of them were losing time when they didn’t have to.”

Dr Moss said the insight provided another reason to improve the rates of endometriosis diagnosis, so women could go into fertility treatment with all the facts.

“It’s essential to catch undiagnosed endo before they start fertility treatment,” she said.

“It’s really important women experiencing symptoms like very painful periods, excessive bleeding and irregular periods go to the doctor and get diagnosed.”

The researchers used data from the Australian Longitudinal Study on Women’s Health for their study, with the results published in the journal Human Reproduction.

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