ENDOMETRIOSIS IN WOMEN OF REPRODUCTIVE AGE IN KAZAKHSTAN: DIAGNOSTIC AND THERAPEUTIC DIFFICULTIES

OBJECTIVE: This review aims to examine the current diagnostic and therapeutic challenges associated with endometriosis in women of reproductive age in Kazakhstan and globally. The goal is to identify existing gaps in care and propose improvements in diagnosis, treatment, and health policy. MATERIALS AND METHODS: A comprehensive literature review was conducted using English-language studies published up to July 2025. Databases such as PubMed, Scopus, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched using keywords: «infertility», «epidemiology», «prevalence», «Kazakhstan», and «endometriosis». Only peer-reviewed studies were included. RESULTS: The global prevalence of endometriosis is estimated at approximately 10%, yet data from Kazakhstan's national electronic health system shows a significantly lower rate of 0.12%, indicating underdiagnosis. Delays in diagnosis, often reaching several years, are linked to insufficient awareness, lack of non-invasive diagnostic tools, and limited access to specialised care, especially in rural regions. Diagnostic laparoscopy remains the gold standard, but its invasive nature restricts widespread use. Recurrence rates of up to 67% are reported, often due to incomplete lesion removal. Hormonal therapy remains the mainstay of treatment, although it does not offer a definitive cure. Promising innovations, including cytokine biomarker panels, nanotechnology, and stem cell therapy, are being explored. A multidisciplinary, patient-centered approach is essential for long-term disease management. CONCLUSION: Endometriosis in Kazakhstan remains underdiagnosed and undertreated. Systemic healthcare reforms, improved awareness among both healthcare professionals and the public, and investment in research and technology are critical. Early diagnosis and personalised, multidisciplinary care can significantly improve outcomes and quality of life for affected women.