Abstract
BackgroundThe quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases.MethodsThe present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility Outpatient Clinic of the Instituto Ideia Fértil de Saúde Reprodutiva, Faculdade de Medicina do ABC, São Paulo, Brazil, were and responded to the Short Form (SF) Health Survey-36. Convenience sampling was used due to the authors’ access to the study population; however, the sample number was calculated to be sufficient for 95% power in both groups.ResultsHomogeneity was observed between Grade I/II and Grade III/IV staging, with similar mean ages (35.27, ±3.64 years and 34.04, ±3.39 years, respectively, p = 0.133); types of infertility (p = 0.535); infertility time (p = 0.654); degrees of pain (p = 0.849); and symptoms common to endometriosis, namely, dysmenorrhea (p = 0.841), dyspareunia (0.466), chronic pelvic pain (p = 0.295), and intestinal (p = 0.573) or urinary (p = 0.809) diseases. Comparisons of median scores in the QoL domains demonstrated that the distributions of QoL and clinical symptoms were significantly related between the types of dyspareunia and the following domains: physical functioning (p = 0.017), role- emotional (p = 0.013), and general health (p = 0.001). Regarding pain outside of menstruation, there was significance in the pain domain (p = 0.017), and degree of pain was significance in physical functioning (p = 0.005) and role-physical (p = 0.011) domains.ConclusionsThe present study pointed out that it is not the stage of endometriosis that interferes in the quality of life of women with endometriosis and infertility but rather the clinical manifestations, such as dyspareunia and pain. Thus, we can conclude that the patient’s perception of the disease should be considered in health care and that the losses are independent of the degree of endometriosis in this population with the aggravating factor of infertility.
Highlights
The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases
QoL related to disease staging No statistically significant differences were found in the QoL domains between the groups based on the degree of endometriosis
When the adopted cutoffs were verified, lower values were identified for stage I/II in the domains of general health, vitality, and mental health; and for stage III/IV in the domains of pain, vitality, and mental health (Table 2)
Summary
The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases. Endometriosis is a heterogeneous disease characterized by the presence of endometrial tissue outside the uterine cavity. It may be asymptomatic or could include clinical manifestations such as chronic pelvic pain, dysmenorrhea, dyspareunia, dysuria, pain after the menstrual period, and infertility [1,2,3,4]. Due to the chronicity of endometriosis, it may be associated with considerable physical and emotional morbidity; and it is known that disease carriers experience harm in their daily activities, which has an economic impact due to a reduction or loss of working hours and hospitalizations [13, 14] It is a disease that can lead to social isolation; and such behavior may be related to pain and fatigue that trigger psychological alterations; loss of productivity and yield at work; whilst its recurrence has the greatest negative impact on psychological health, vitality, financial conditions, and reduction in social activities [8,9,10,11].
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