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Prevalence, clinical profile of endometriosis among infertile women with normospermic partners and treatment options

Nayana D.H, Shreya M S, Swagatha.




Abstract
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Background: Endometriosis is a chronic inflammatory disease affecting women of reproductive age. Studies have suggested that 25 to 50% of infertile women have endometriosis. However, the true prevalence is difficult to ascertain. The study's objective was to determine the prevalence of endometriosis in a subset of sub-fertile women undergoing hysteron-laparoscopy and evaluate risk factors and clinical and laparoscopic characteristics of endometriosis therapeutic interventions done in the same setting.
Methods: it was a cross-sectional study of 90 women undergoing hystero-laparoscopy for primary or secondary infertility. endometriosis was diagnosed laparoscopically in 30 %. Staging of endometriosis was done according to r.AFS scoring.
Results: Out of 90 subjects, 27 (30%) had laparoscopic evidence of endometriosis. Out of 27 cases studied, 10 (37%) had minimal, 6(22.2%) had moderate, and 9(33.3%) had severe endometriosis. The commonest complaint was dysmenorrhea which was present in 92%. Only 10 % were asymptomatic.
Conclusion: Infertile women attending infertility clinic undergoing diagnostic hysteron-laparoscopy for evaluation, even minimal disease without symptomatology prior could be picked up. Increasing prevalence is because of the increased use of laparoscopy as a diagnostic modality and increased awareness about symptom profiles among reproductive women. additionally, among patients undergoing hystero-laparoscopy, even minimal disease could be diagnosed. Our study shows a higher incidence among infertile women. It shows that risk factors like early menarche and frequent cycles are associated with an increased risk of endometriosis. Also, symptoms like dysmenorrhea and dyspareunia strongly correlate with the underlying severity of the disease and also the stage of the disease.

Key words: Endometriosis, Infertility, Hysterolaproscopy






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