Matches in SemOpenAlex for { <https://semopenalex.org/work/W4383172259> ?p ?o ?g. }
- W4383172259 endingPage "1528" @default.
- W4383172259 startingPage "1520" @default.
- W4383172259 abstract "Do women with endometriosis have lower first live birth rate before surgical diagnosis than women without verified endometriosis?Compared to reference women, the incidence of first live birth was lower in women prior to surgical verification of endometriosis irrespective of the type of endometriosis.Endometriosis is associated with pain and reduced fertility. The mechanism of infertility is partly explained by anatomical, endocrinological, and immunological changes. Over the past decades, the treatment of both endometriosis and infertility has evolved. Knowledge of fertility far before surgical diagnosis of endometriosis in large cohorts and of different types of endometriosis has been lacking. The diagnostic delay of endometriosis is long, 6-7 years.Retrospective population-based cohort study focused on the time period before the surgical verification of endometriosis. All women with surgical verification of endometriosis in 1998-2012 were identified from the Finnish Hospital Discharge Register and the reference cohort from the Central Population Register. Data on deliveries, gynecological care, and sociodemographic factors before the surgical diagnosis were gathered from Finnish national registers maintained by the Finnish Institute for Health and Welfare, the Digital and Population Data Services Agency, and Statistics Finland.All women aged 15-49 years at the time of surgical verification of endometriosis (ICD-10: N80.1-N80.9) in Finland during 1998-2012 were identified (n = 21 620). Of them, we excluded women born in 1980-1999 due to the proximity of the surgical diagnosis (n = 3286) and women left without reference (n = 10) for the final endometriosis cohort of 18 324 women. From the final cohort, we selected sub-cohorts of women with isolated diagnosis of ovarian (n = 6384), peritoneal (n = 5789), and deep (n = 1267) endometriosis. Reference women were matched by age and residence and lacked registered clinical or surgical diagnosis of endometriosis (n = 35 793). The follow-up started at the age of 15 years and ended at the first birth, sterilization, bilateral oophorectomy, hysterectomy, or until the surgical diagnosis of endometriosis or corresponding index day-whichever came first. Incidence rate (IR) and the incidence rate ratio (IRR) of first live birth before the surgical verification of endometriosis with corresponding CIs were calculated. In addition, we reported the fertility rate of parous women (the number of all children divided by the number of parous women in the cohort) until the surgical verification of endometriosis. The trends in first births were analysed according to the women's birth cohort, type of endometriosis, and age.Surgical diagnosis of endometriosis was set at the median age of 35.0 years (IQR 30.0-41.4). Altogether 7363 women (40.2%) with endometriosis and 23 718 (66.3%) women without endometriosis delivered a live born infant before the index day (surgery). The IRs of the first live birth per 100 person-years were 2.64 (95% CI 2.58-2.70) in the endometriosis cohort and 5.21 (95% CI 5.15-5.28) in the reference cohort. Between the endometriosis sub-cohorts, the IRs were similar. The IRR of the first live birth was 0.51 (95% CI 0.49-0.52) between the endometriosis and reference cohorts. Fertility rate per parous woman before the surgical diagnosis was 1.93 (SD 1.00) and 2.16 (SD 1.15) in the endometriosis and reference cohorts (P < 0.01). The median age at the first live birth was 25.5 (IQR 22.3-28.9) and 25.5 (IQR 22.3-28.6) years (P = 0.01), respectively. Between the endometriosis sub-cohorts, women in the ovarian sub-cohort were the oldest at the time of surgical diagnosis with the median age of 37.2 years (IQR 31.4-43.3), (P < 0.001). Altogether 44.1% (2814) of the women with ovarian, 39.4% (2282) with peritoneal, and 40.8% (517) with deep endometriosis delivered a live born infant before the diagnosis. IRRs between the endometriosis sub-cohorts did not differ. Fertility rate per parous woman was lowest, 1.88 (SD 0.95), in the ovarian sub-cohort compared to 1.98 (SD 1.07) in the peritoneal and 2.04 (SD 0.96) in deep endometriosis (P < 0.001). Women with ovarian endometriosis were oldest at first live birth compared to women in other sub-cohorts with a median age of 25.8 years (IQR 22.6-29.1) (P < 0.001). Cumulative distributions of first live birth were presented according to age at first live birth and birth cohorts of the participants.The increasing age at first live birth, increasing practice of clinical diagnostics, conservative treatment of endometriosis, a possible effect of coexisting adenomyosis, and use of artificial reproductive treatments should be considered when assessing the results. In addition, the study is limited due to possible confounding effects of socioeconomic factors, such as level of education. It should be noted that, in this study, we assessed parity only during the years preceding the surgical verification of endometriosis.The need for early diagnosis and relevant treatment of endometriosis appears clear given the impairment of fertility prior to its surgical verification.The study was funded by the Hospital District of Helsinki and Uusimaa and by Finska Läkaresällskapet. The authors report no conflicts of interest. All authors have completed the ICMJE Disclosure form.N/A." @default.
- W4383172259 created "2023-07-05" @default.
- W4383172259 creator A5005794861 @default.
- W4383172259 creator A5012438434 @default.
- W4383172259 creator A5013568187 @default.
- W4383172259 creator A5023299548 @default.
- W4383172259 creator A5033960016 @default.
- W4383172259 creator A5051128925 @default.
- W4383172259 creator A5080968906 @default.
- W4383172259 date "2023-07-04" @default.
- W4383172259 modified "2023-10-01" @default.
- W4383172259 title "First live birth before surgical verification of endometriosis—a nationwide register study of 18 324 women" @default.
- W4383172259 cites W1638782310 @default.
- W4383172259 cites W1973998429 @default.
- W4383172259 cites W1994538221 @default.
- W4383172259 cites W2004505189 @default.
- W4383172259 cites W2060788809 @default.
- W4383172259 cites W2066000005 @default.
- W4383172259 cites W2111297082 @default.
- W4383172259 cites W2140672255 @default.
- W4383172259 cites W2158134092 @default.
- W4383172259 cites W2212216218 @default.
- W4383172259 cites W2232032155 @default.
- W4383172259 cites W2318998837 @default.
- W4383172259 cites W2411259387 @default.
- W4383172259 cites W2467381763 @default.
- W4383172259 cites W2584032603 @default.
- W4383172259 cites W2604588554 @default.
- W4383172259 cites W2607271160 @default.
- W4383172259 cites W2616851367 @default.
- W4383172259 cites W2622380777 @default.
- W4383172259 cites W2761330356 @default.
- W4383172259 cites W2800794667 @default.
- W4383172259 cites W2884993459 @default.
- W4383172259 cites W2891883011 @default.
- W4383172259 cites W2898565582 @default.
- W4383172259 cites W2899812558 @default.
- W4383172259 cites W2962732120 @default.
- W4383172259 cites W2989135331 @default.
- W4383172259 cites W3007768130 @default.
- W4383172259 cites W3091709476 @default.
- W4383172259 cites W3127684117 @default.
- W4383172259 cites W3134885188 @default.
- W4383172259 cites W3189071847 @default.
- W4383172259 cites W3202666415 @default.
- W4383172259 cites W3205945027 @default.
- W4383172259 cites W4211250493 @default.
- W4383172259 cites W4214754424 @default.
- W4383172259 cites W4224308528 @default.
- W4383172259 cites W4234160457 @default.
- W4383172259 cites W4293117327 @default.
- W4383172259 cites W4294440057 @default.
- W4383172259 doi "https://doi.org/10.1093/humrep/dead120" @default.
- W4383172259 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37403272" @default.
- W4383172259 hasPublicationYear "2023" @default.
- W4383172259 type Work @default.
- W4383172259 citedByCount "0" @default.
- W4383172259 crossrefType "journal-article" @default.
- W4383172259 hasAuthorship W4383172259A5005794861 @default.
- W4383172259 hasAuthorship W4383172259A5012438434 @default.
- W4383172259 hasAuthorship W4383172259A5013568187 @default.
- W4383172259 hasAuthorship W4383172259A5023299548 @default.
- W4383172259 hasAuthorship W4383172259A5033960016 @default.
- W4383172259 hasAuthorship W4383172259A5051128925 @default.
- W4383172259 hasAuthorship W4383172259A5080968906 @default.
- W4383172259 hasBestOaLocation W43831722591 @default.
- W4383172259 hasConcept C120665830 @default.
- W4383172259 hasConcept C121332964 @default.
- W4383172259 hasConcept C126322002 @default.
- W4383172259 hasConcept C131872663 @default.
- W4383172259 hasConcept C141071460 @default.
- W4383172259 hasConcept C167135981 @default.
- W4383172259 hasConcept C2777688143 @default.
- W4383172259 hasConcept C2779234561 @default.
- W4383172259 hasConcept C2779522080 @default.
- W4383172259 hasConcept C2780136519 @default.
- W4383172259 hasConcept C2908647359 @default.
- W4383172259 hasConcept C29456083 @default.
- W4383172259 hasConcept C518429986 @default.
- W4383172259 hasConcept C54355233 @default.
- W4383172259 hasConcept C61511704 @default.
- W4383172259 hasConcept C71924100 @default.
- W4383172259 hasConcept C72563966 @default.
- W4383172259 hasConcept C86803240 @default.
- W4383172259 hasConcept C99454951 @default.
- W4383172259 hasConceptScore W4383172259C120665830 @default.
- W4383172259 hasConceptScore W4383172259C121332964 @default.
- W4383172259 hasConceptScore W4383172259C126322002 @default.
- W4383172259 hasConceptScore W4383172259C131872663 @default.
- W4383172259 hasConceptScore W4383172259C141071460 @default.
- W4383172259 hasConceptScore W4383172259C167135981 @default.
- W4383172259 hasConceptScore W4383172259C2777688143 @default.
- W4383172259 hasConceptScore W4383172259C2779234561 @default.
- W4383172259 hasConceptScore W4383172259C2779522080 @default.
- W4383172259 hasConceptScore W4383172259C2780136519 @default.
- W4383172259 hasConceptScore W4383172259C2908647359 @default.
- W4383172259 hasConceptScore W4383172259C29456083 @default.
- W4383172259 hasConceptScore W4383172259C518429986 @default.