Endometriosis

The Subfertility Handbook Buy print or eBook [Opens in a new window] A Clinician's Guide - Frontmatter - Contents - List of contributors - 1 Introduction - 2 The first interview with an infertile couple - 3 Assessment of the female partner - 4 Assessment of the male partner - 5 Treatment options for male subfertility - 6 Management of the woman with chronic anovulation - 7 Cervical factor, unexplained subfertility and artificial insemination with husband sperm - 8 In-vitro fertilization: indications, stimulation and clinical techniques - 9 The role of gamete intrafallopian transfer - 10 The use of assisted reproductive technology for the treatment of male infertility - 11 The use of donor insemination - 12 The donor egg programme - 13 Endometriosis - 14 The role of ultrasound in subfertility - 15 The role of surgery in infertility - 16 Laboratory techniques - 17 The results of assisted reproductive technology - 18 Infertility counselling - Index Published online by Cambridge University Press: 06 July 2010 Edited by Book contents - Frontmatter - Contents - List of contributors - 1 Introduction - 2 The first interview with an infertile couple - 3 Assessment of the female partner - 4 Assessment of the male partner - 5 Treatment options for male subfertility - 6 Management of the woman with chronic anovulation - 7 Cervical factor, unexplained subfertility and artificial insemination with husband sperm - 8 In-vitro fertilization: indications, stimulation and clinical techniques - 9 The role of gamete intrafallopian transfer - 10 The use of assisted reproductive technology for the treatment of male infertility - 11 The use of donor insemination - 12 The donor egg programme - 13 Endometriosis - 14 The role of ultrasound in subfertility - 15 The role of surgery in infertility - 16 Laboratory techniques - 17 The results of assisted reproductive technology - 18 Infertility counselling - Index Endometriosis is one of the most frequently encountered gynaecological diseases. Its aetiology, physiology and treatment remain controversial. This chapter covers the diagnosis, aetiology, assessment and treatment options for this disorder and discusses its role in infertility and prognosis after treatment. Incidence The true incidence of endometriosis remains unknown, despite a number of studies that have tried to estimate it. One study stated that 10–15% of all premenopausal women had this disorder (Hasson, 1976); another found it in 10–15% of women undergoing diagnostic laparoscopy for pain, infertility and dysmenorrhoea. The latter study also looked at women undergoing laparoscopic sterilization and found that only 2–5% had endometriosis (Strathy, Molgaard and Coulman, 1982). It also looked at women with infertility alone and found that 30–40% of women who underwent laparoscopy for infertility had endometriosis. The conclusion was that endometriosis had to be related in some way to infertility as either an association or a cause or effect. Pathogenesis Before pathogenesis can be discussed, it is important to have a uniformly accepted definition of the disease. The gold standard in diagnosis is the presence of histologically documented menstrual glands and stroma outside the uterus. It also helps if there is evidence of menstrual cyclicity with haemosiderin-laden macrophages. Coelomic metaplasia This was the first widely considered theory of the pathogenesis of endometriosis. According to this proposal, in response to certain unspecified stimuli, cells may undergo a metaplastic process which changes their character and physiological function. - Type - Chapter - Information - The Subfertility HandbookA Clinician's Guide, pp. 163 - 175Publisher: Cambridge University PressPrint publication year: 1997 Accessibility compliance for the PDF of this chapter is currently unknown and may be updated in the future. 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