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O-171 Quality improvement in endometriosis fertility care


 Women with endometriosis often present with abdominal pain, dysmenorrhoea, dyspareunia and infertility. As a definitive cure for endometriosis is lacking, women with endometriosis are usually in need of long-term treatment which may be recurring if periods of non-treatment are employed. Women with endometriosis often report the feeling of not being heard, not taken seriously and having had different advices from different health care providers. Around half of women with endometriosis are dissatisfied with their medical support. Clear and consistent counselling is one of the important aspects of care that women with endometriosis report to be poor. 
 Infertile women with endometriosis need to consider different aspects before being able to conceive: i) each natural cycle no pregnancy is achieved, endometriosis complaints might recur or aggravate, ii) hormonal treatment of endometriosis is contraceptive and prevents pregnancy, iii) surgical treatment might increase natural chances or make ART possible but could cause ovarian damage, and iv) ART might shorten time to pregnancy and increase chances, but does not allow for natural conception. Advice on fertility care, including ART and surgery, is often based on moderate to poor quality evidence and experts’ opinions.
 It is important to be able to counsel women with endometriosis adequately, especially when multiple treatments are available and there is no one perfect treatment. Therefore, good quality of care and insights in patient preferences are key. It is important to understand current patient-centeredness of endometriosis care. What can be improved? How can we best support women with endometriosis? What do they need? What are their experiences and how should we change our care in the future?