Clinical Profile and Correlation between Endometriosis in Infertile Women in Tertiary Health Care of India

Background: Patients with endometriosis mainly complain of pelvic pain, dysmenorrhea, and dyspareunia.Approximate prevalence of endometriosis is 6-8%.A combination of surgical treatment and either preoperative or postoperative medical therapy has been suggested for endometriosis.Clinical impression of low incidence in Indian women may have been due to limited medical and diagnostic facilities available.So, we planned this study to evaluate the prevalence and clinical profile of endometriosis in Indian infertile women.Material and Methods: The present cross sectional, prospective and observational study was conducted on 50 women of ages 18-40 years, with history of primary or secondary infertility and whose husband semen analysis was normal, attending the Obstetrics and gynecology department during the period of February 2021 to January 2022, at tertiary health center, were included. All the suspected cases of endometriosis were undergone to laparoscopic examination. Diagnosed Endometriosis was scored and classified in stage-1, stage-II, stage-III and stage IV according to revised AmericanFertility Society Classification.Appropriate software and test applied to find the statistically significant difference.P value <0.05 was considered as statistically significant.Results: Majority (50.98%) of the patients had age range 21-26 years.Mean age of the patients were 24.35 ± 4.02.Highest (52.94%) number of patients had BMI 18.5-22.9followed by BMI 23-24.9present in 29.41% patients.Majority (70.59%) of the patients had primary infertility. Majority (37.25%) of the patients had mild (stage-II) disease and 29.41% patients had moderate (stage-III). Patients in stage-II disease, 7 patients (36.84%) had pelvic pain and in stage-III out of 15 patients, 5 patients (33.33%) had pelvic pain. In stage-II disease, 09 patients (47.38%) had heavy menses and in stage-III, 8 patients (53.33%) had heavy menses. Patients in stage-II disease, 09 patients (47.38%) had dyspareunia and in stage-III, 09 patients (60%) had dyspareunia. Patients in stage-III disease, 06 patients (40%) had adnexal mass and in stage-II, 04 patients (21.05%) had adnexal mass. Mean estradiol, prolactin, cortisol CA-125 and T3, T4 and TSH levels were highest in stage IV and mean FSH and LH levels were highest in stage I. Conclusion: Prevalence of endometriosis in infertile women was 33.33%. The common clinical features are dysmenorrhea, irregular and heavy menses, dyspareunia, pelvic pain and tenderness. As the severity of the disease increases the hormonal derangement also increases. High level of estradiol was present in patients with stage-III and IV disease.