This patient's condition increases her risk for which of the following complications?

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11ec25c8_d9be_7fa8_bc81_87d1e102a43e_MD0003_00 Due to the chronic proliferation of ectopic endometrial implants in the abdominopelvic cavity, patients with endometriosis develop intraperitoneal inflammation and fibrosis. Therefore, a common complication of endometriosis is infertility. In these patients, inflammation interferes with fertilization by decreasing sperm motility; in addition, adhesion formation and pelvic anatomy distortion can cause tubal obstruction and impaired implantation. Treatment is with laparoscopic removal of inflammatory implants and lysis of adhesions, which improves fertility by decreasing inflammation and restoring pelvic anatomy. endometrial implants (Choice A) Endometrial cancer occurs in patients with unopposed estrogen stimulation (eg, obesity, polycystic ovary syndrome) due to uncontrolled endometrial proliferation. Endometriosis is estrogen-responsive; however, it does not increase endometrial cancer risk because gland proliferation is outside the uterus (rather than an overproliferation of the endometrium). (Choice C) Intrauterine adhesions can result from pelvic inflammatory disease (eg, endometritis), which typically presents with abnormal uterine bleeding or vaginal discharge. Endometriosis is an extrauterine disease. (Choices D and E) The risk of osteoporotic fracture is higher in patients with disorders of the hypothalamic-pituitary-ovarian axis that cause low estrogen levels (eg, functional hypothalamic amenorrhea, primary ovarian insufficiency). Endometriosis does not involve the hypothalamic-pituitary-ovarian axis and does not affect estrogen levels. (Choice F) Recurrent miscarriage typically occurs in patients with intrauterine cavity abnormalities (eg, septate uterus). Although endometriosis affects fertility, it is an extrauterine disease; therefore, it does not increase the risk of recurrent miscarriage. septate uterus Educational objective: Patients with endometriosis are at increased risk of infertility due to chronic pelvic inflammation, adhesion formation, and distorted pelvic anatomy. References: Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. (http://www.ncbi.nlm.nih.gov/pubmed/23182559) Laparoscopic surgery for endometriosis. (http://www.ncbi.nlm.nih.gov/pubmed/24696265)

This Patient's Condition Increases Her Risk for Which of the Following