Uterine Anomalies in Women with Endometriosis

Abstract

Objective Uterine anomalies are associated with higher rate of infertility, spontaneous abortion, premature birth and endometriosis. We report our experience in 13 cases with uterine malformations and endometriosis. Methods The medical files of 425 cases with endometriosis and 200 without endometriosis, all of them studied by laparoscopy, were studied retrospectively in Yale University Hospital. Thirteen cases were observed and analyzed. Outcome measures Presenting symptoms, stage of endometriosis, menstrual characteristics, obstetrics outcome, family history, the type of uterine anomaly and presence of other anomalies were studied. Results In our series, we found 13/425 (3%) of women with endometriosis and congenital malformation. The mean age was 29.6 years (range 25–30). In this population, septate uterus (54%) was the most common malformation, followed by didelphic uterus (23%), unicornuate uterus (15.3%) and bicornuate uterus (7.7%). In 3 (23%) of these patients, we observed anomalies of the urinary tract. In the control group, we found only one case (0.5%) with septate uterus. Seven out of 13 (54%) of patients had severe endometriosis. The main symptom of all patients was infertility. Five out of thirteen conceived after assisted reproductive technology (ART) procedures. Five cases (38%) were found with first-degree family history with endometriosis. Conclusions Our results seem to support a link between uterine anomalies and subsequent development of endometriosis with infertility. The role of ART needs to be better evaluated. The co-existence of uterine anomalies with endometriosis and familiar aggregation of endometriosis should be examined in future studies, in order to improve our understanding of the genetic aspect of these diseases.