Publication:

Frequency of endometriosis among infertile women and association of clinical presentations with laparoscopic findings in center for assisted reproduction, BIRDEM

Background Endometriosis is a significant cause of infertility, particularly among women of reproductive age. It often presents with symptoms such as pelvic pain, dysmenorrhoea, and dyspareunia. Laparoscopy is still the gold standard for diagnosing and staging endometriosis. This study aimed to determine the frequency of endometriosis among infertile women undergoing diagnostic laparoscopy and to assess the association of clinical symptoms with disease severity.

Methods A cross-sectional descriptive study was conducted at the Center for Assisted Reproduction (CARE), BIRDEM General Hospital, Dhaka, Bangladesh, from July 2013 to June 2015. A total of 127 infertile women, both primary and secondary, undergoing diagnostic laparoscopy and dye test were enrolled. Data were analyzed using SPSS version 20, with a p-value <0.05 considered statistically significant.

Results Endometriosis was detected in 18.9% of participants. The mean age was 29.31±4.08 years. Most women had normal (36.22%) or overweight (34.65%) BMI. Secondary infertility was more common (71.65%), but endometriosis was significantly associated with primary infertility (p=0.004). Clinical symptoms, including severe dysmenorrhoea, chronic pelvic pain, and dyspareunia, were significantly associated with endometriosis (p<0.05). Stage II endometriosis was significantly linked with chronic pelvic pain and moderate to severe dysmenorrhoea (p=0.002, 0.004), while stage IV was associated with severe dysmenorrhoea, menorrhagia, and dyspareunia (p=0.016, 0.004, 0.010, respectively). Menorrhagia had an inverse association with endometriosis overall.

Conclusions Endometriosis is more frequently associated with primary infertility and specific pelvic symptoms, particularly at advanced stages. Laparoscopy remains essential for accurate diagnosis and staging.