{"paper_id":"04df6354-8200-4a45-aa2c-72077595ff2d","body_text":"Content uploaded by Lara M. Samhan\nAuthor content\nAll content in this area was uploaded by Lara M. Samhan on Apr 20, 2025\nContent may be subject to copyright.\nContent uploaded by Noor Elabd\nAuthor content\nAll content in this area was uploaded by Noor Elabd on Feb 27, 2025\nContent may be subject to copyright.\nDiscussion\n•Endometriosis is a gynaecological condition commonly linked to infertility and pregnancy complications, yet some cases, like ours,\nshow successful pregnancy without major complications.\n•The absence of endometriomas in our patient may explain the lack of severe complications, unlike cases where endometriomas\ncaused ileal perforation, abscess formation, and emergency delivery.\n•Prior surgery for endometriosis has been associated with higher risks of preterm birth and placenta previa, but our patient had no\nhistory of surgery, which may have contributed to a smoother pregnancy.\n•Studies report increased risks of preeclampsia and gestational diabetes in women with endometriosis, though our case suggests\nthat the absence of endometriomas may reduce these risks.\nIntroduction\n•Endometriosis is a chronic gynaecological condition affecting around 10% of women world-wide, it is characterised by ectopic\nendometrial tissue.\n•It is associated with chronic pelvic pain, dysmenorrhea, and infertility.\n•Endometriosis has been linked to adverse pregnancy outcomes, including preterm birth and placental complications, though not all\ncases lead to such issues.\n•This case highlights a patient with concurrent PCOS, longstanding dysmenorrhea, and MRI findings indicative of endometriosis\nwithout endometriomas.\n•The findings emphasise the importance of early diagnosis and individualised management to improve reproductive outcomes and\nsymptom control.\nCase Presentation\n•A 26-year-old female presented with features of PCOS, including oligomenorrhoea, facial acne, and an elevated LH/FSH ratio, along\nwith a 12-year history of dysmenorrhea unrelieved by analgesics, radiating to the back, and associated with diarrhea.\n•MRI pelvis with IV contrast revealed an anteverted, retroflexed uterus (2.6×3.8×5.3 cm), a dark T2W1 band along the posterior\ntorus uterus, low T2 signal outlining the serosal surface, and thickening of the bilateral round ligaments, consistent with\nendometriosis but no endometriomas.\n•The patient had been on OCPs but discontinued them to conceive, starting prenatal folic acid and previously using Visanne\n(dienogest) for symptom management of endometriosis.\n•Laboratory results showed FSH 8.3 mIU/mL, LH 49.8 mIU/mL, and prolactin 18.7 ng/mL, indicating hormonal imbalances related to\nPCOS.\n•Despite the coexistence of PCOS and endometriosis-related symptoms, the patient remained stable and reported no complications\nduring pregnancy.\n•She continues to be under regular follow-up, reinforcing the importance of individualised management in patients with concurrent\nPCOS and endometriosis.\nConclusion\n•This case highlights a successful pregnancy in a patient with both PCOS and endometriosis, suggesting that the absence of\nendometriomas may reduce pregnancy complications.\n•Individualised management and close monitoring remain crucial for optimising outcomes in similar cases.\nNoor Elabd 2,Lara Samhan 2, Sara Samhan 2, Alhanof Althowaini 2, Sadia Malick 1\n1 King Faisal Specialist Hospital and Research Center, Riyadh, KSA\n2College of Medicine, Alfaisal University, Riyadh, KSA\nA Novel Case of Pregnancy Alongside Endometriosis, A Case\nReport and Review of the Literature\nReferences\nUGM0103\nAbstract\nA 26-year-old female with a 12-year history of dysmenorrhea and PCOS symptoms (oligomenorrhea, acne, elevated LH/FSH) sought\npregnancy after discontinuing oral contraceptives. MRI revealed an anteverted, retroflexed uterus with features of endometriosis—\nincluding a dark T2W1 band and thickened round ligaments—but no endometriomas. She began treatment with Visanne and folic acid\nsupplementation. Currently, the patient remains pregnant without complications. This case underscores that uncomplicated pregnancies\nare possible in women with endometriosis, particularly in the absence of endometriomas.\nObjectives\nTo present a unique case of a 26-year-old female with endometriosis absent of endometriomas who achieved an uncomplicated\npregnancy and to explore its implications for managing endometriosis-related fertility.\n010 20 30 40 50 60\nLH (IU/L)\nFSH (IU/L)\nProlactin (ng/mL)\nPatient Value Normal Range (Median)\nFig. 1: Axial T2-weighted MRI of the pelvis showing a distinct area of low T2 signal intensity\n(arrow) along the posterior aspect of the uterus. No endometriomas are identified.\nFig. 3: Sagittal T2-weighted MRI of the pelvis demonstrating a\nlow T2 signal band along the posterior uterine surface, with\nno visible endometriomas. The bladder is seen anteriorly, and\nthe uterus appears anteverted and retroflexed.\nFig. 2 Explanation:\n•FSH: The patient's FSH (8.3 IU/L) is comparable to the normal median (~8 IU/L).\n•LH: The patient’s LH (49.8 IU/L) is significantly elevated compared to the normal median (~6 IU/L), consistent with PCOS.\n•Prolactin: The patient's prolactin (18.7 ng/mL) is slightly above the normal median (~12 ng/mL) but remains near the upper limit of normal.","source_license":"CC0","license_restricted":false}