Non-invasive diagnosis of endometriosis, a revolutionary step in reproductive endocrinology

Abstract Endometriosis is defined as presence of endometrial glands and stroma out of the uterine cavity. Symptoms of the disease which affects 10–15% of women of reproductive age are chronic pelvic pain, dysmenorrhoea, dyspareunia and infertility. Although definitive diagnosis of endometriosis is made by histopathological examination of surgically removed tissue, non-invasive tests have become important for diagnosis because of possible difficulties of surgical diagnosis such as patient’s fear of invasive procedures, risks of surgical complication or failure to show the endometriotic lesions by surgical inspection. To date, there is no any non-invasive test for the diagnosis of endometriosis that is routinely used in clinical practice. Developments and standardization in non-invasive diagnostic test instruments are getting important in terms of early diagnosis ( and thus early treatment) and patient comfort. In this review we summarise the non-invasive methods which are currently used and discuss a number of candidate methods including specific serum tests, imaging modalities and eutopic endometrial markers for the non-invasive diagnosis of endometriosis have been discussed along with the relevant literature.