FFHA Newsletter – April 2026
When Endometriosis and Adenomyosis Occur Together: What It Means for Fertility and Pregnancy
This review looked at women who have both endometriosis (a condition where tissue like the lining of the uterus grows outside the uterus) and adenomyosis (that tissue grows into the muscle wall of the uterus) and how this affects fertility and pregnancy. The authors analyzed 14 studies from 2000–2024 and found that women with both conditions had lower chances of getting pregnant and having a live birth, including during IVF. They also saw signs of higher risks for some pregnancy problems, like miscarriage, pre-eclampsia (dangerous high blood pressure in pregnancy), placenta previa (placenta covering the cervix), preterm birth, and babies small for gestational age, but results were mixed. The risks seemed higher when adenomyosis was more severe, yet not all studies agreed, and many studies used different methods. Because endometriosis and adenomyosis often happen together, the authors suggest doctors check for both and talk with patients about possible lower pregnancy chances and the need for closer care in pregnancy. For women planning a family, this means asking your doctor about testing for adenomyosis if you have endometriosis (and the other way around), and discussing a plan to support getting pregnant and having a healthy pregnancy.
Having both endometriosis and adenomyosis may lower pregnancy and birth rates and could raise some pregnancy risks, so awareness and personalized care matter.
Koroneos Z, Cao M, Mooney S, Tyson K, Holdsworth-Carson S. Comorbidity of endometriosis and adenomyosis: A systematic review examining the impact of co-morbid disease on fertility and pregnancy outcomes. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2026;322:115094. doi:10.1016/j.ejogrb.2026.
Global Trends in Infertility from STIs: What Women Should Know (1990–2021)
Researchers used the Global Burden of Disease to study how often infertility caused by sexually transmitted infections affected women from 1990 to 2021. They examined primary infertility (never had a prior pregnancy) and secondary infertility (had a past pregnancy but now cannot conceive) and found that, overall, levels stayed about the same worldwide. Low‑income regions showed big drops, but higher‑income regions saw increases that need attention. By germ type, gonorrhea-linked infertility went down, while chlamydia-linked secondary infertility rose a little. The burden grew for women ages 15–34 for secondary infertility and for women ages 40–49 for primary infertility, pointing to the need for age‑targeted screening and fast treatment. The authors call for pathogen‑specific plans, early STI testing and care, condom use, and fair access to services so women everywhere can protect their fertility.
STI‑related infertility is falling in poorer places but rising in richer ones, with chlamydia a growing concern and different age groups needing tailored prevention and care.
Li, T., Long, S., Ye, Z., Tang, Z., Song, Y., Su, M., Zhou, B., Wang, Y., & Zhang, L. (2026). Distribution and trends of the global burden of female infertility attributable to sexually transmitted infections from 1990 to 2021. BMC Infectious Diseases, 26, 492. https://doi.org/10.1186/
STIs in Early Pregnancy: Higher Risk Under 25, No Clear Link to Complications
This study looked at how common sexually transmitted infections are in early pregnancy and whether they are tied to pregnancy problems. Doctors tested 742 women in their first trimester using a vaginal swab and a PCR test (a lab test that looks for germ DNA) for several germs, including Chlamydia trachomatis and Mycoplasma genitalium (a tiny germ passed during sex). About 1 in 20 had an STI (4.7%), but rates were much higher in women 25 and younger (15.6%), with both chlamydia and Mycoplasma genitalium at 7.8% in that age group. More than half carried at least one germ, and coinfection was common, often involving Ureaplasma parvum (a common vaginal bacterium that doesn’t always cause disease). Pregnancy complications happened in 12.4% of pregnancies, mainly miscarriages and preterm birth, but no specific STI was clearly linked to these problems. The authors suggest keeping targeted screening for women 25 and younger and call for more research on Mycoplasma genitalium and its impact on moms and babies.
Young pregnant women had higher STI rates, targeted testing for those 25 and under still makes sense, and more study is needed on Mycoplasma genitalium.
López-Corbeto E, González Soler V, Tejada G, Ramírez Marinero A, Casabona J, Martínez Bueno C; on behalf of the EMBITS study group. Sexually transmitted infections in pregnancy: Prevalence, coinfections, and pregnancy complications. Enfermedades Infecciosas y Microbiologia Clinica. 2026;44:503102. Published online March 26, 2026.
