Frequency of endometriosis among infertile women and association of clinical presentations with laparoscopic findings in center for assisted reproduction, BIRDEM

In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(7) , pp. 2111–2117 · doi:10.18203/2320-1770.ijrcog20251955 · W4411679920
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This study found endometriosis in 18.9% of infertile women, significantly associated with primary infertility and symptoms like dysmenorrhoea and pelvic pain, which correlated with disease stage.

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This cross-sectional descriptive study evaluated 127 infertile women (primary and secondary) undergoing diagnostic laparoscopy with dye testing at BIRDEM General Hospital (July 2013–June 2015) to estimate the frequency of endometriosis and to assess associations between symptoms and laparoscopic stage. Endometriosis was found in 18.9% of participants, and it was significantly associated with primary infertility; severe dysmenorrhoea, chronic pelvic pain, and dyspareunia were also significantly associated with endometriosis, with specific symptom patterns varying by stage (e.g., stage IV with severe dysmenorrhoea, menorrhagia, and dyspareunia; menorrhagia inversely associated overall). The paper’s main caveat is that it is limited to women undergoing diagnostic laparoscopy in a single center, which may affect generalizability. This paper is centrally about endometriosis — it quantifies endometriosis frequency among infertile women and links clinical presentations to laparoscopic disease severity.

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Abstract

Background: Endometriosis is a significant cause of infertility, particularly among women of reproductive age. It often presents with symptoms such as pelvic pain, dysmenorrhoea, and dyspareunia. Laparoscopy is still the gold standard for diagnosing and staging endometriosis. This study aimed to determine the frequency of endometriosis among infertile women undergoing diagnostic laparoscopy and to assess the association of clinical symptoms with disease severity. Methods: A cross-sectional descriptive study was conducted at the Center for Assisted Reproduction (CARE), BIRDEM General Hospital, Dhaka, Bangladesh, from July 2013 to June 2015. A total of 127 infertile women, both primary and secondary, undergoing diagnostic laparoscopy and dye test were enrolled. Data were analyzed using SPSS version 20, with a p-value <0.05 considered statistically significant. Results: Endometriosis was detected in 18.9% of participants. The mean age was 29.31±4.08 years. Most women had normal (36.22%) or overweight (34.65%) BMI. Secondary infertility was more common (71.65%), but endometriosis was significantly associated with primary infertility (p=0.004). Clinical symptoms, including severe dysmenorrhoea, chronic pelvic pain, and dyspareunia, were significantly associated with endometriosis (p<0.05). Stage II endometriosis was significantly linked with chronic pelvic pain and moderate to severe dysmenorrhoea (p=0.002, 0.004), while stage IV was associated with severe dysmenorrhoea, menorrhagia, and dyspareunia (p=0.016, 0.004, 0.010, respectively). Menorrhagia had an inverse association with endometriosis overall. Conclusions: Endometriosis is more frequently associated with primary infertility and specific pelvic symptoms, particularly at advanced stages. Laparoscopy remains essential for accurate diagnosis and staging.
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Background

Endometriosis is a significant cause of infertility, particularly among women of reproductive age. It often presents with symptoms such as pelvic pain, dysmenorrhoea, and dyspareunia. Laparoscopy is still the gold standard for diagnosing and staging endometriosis. This study aimed to determine the frequency of endometriosis among infertile women undergoing diagnostic laparoscopy and to assess the association of clinical symptoms with disease severity.

Methods

A cross-sectional descriptive study was conducted at the Center for Assisted Reproduction (CARE), BIRDEM General Hospital, Dhaka, Bangladesh, from July 2013 to June 2015. A total of 127 infertile women, both primary and secondary, undergoing diagnostic laparoscopy and dye test were enrolled. Data were analyzed using SPSS version 20, with a p-value <0.05 considered statistically significant.

Results

Endometriosis was detected in 18.9% of participants. The mean age was 29.31±4.08 years. Most women had normal (36.22%) or overweight (34.65%) BMI. Secondary infertility was more common (71.65%), but endometriosis was significantly associated with primary infertility (p=0.004). Clinical symptoms, including severe dysmenorrhoea, chronic pelvic pain, and dyspareunia, were significantly associated with endometriosis (p<0.05). Stage II endometriosis was significantly linked with chronic pelvic pain and moderate to severe dysmenorrhoea (p=0.002, 0.004), while stage IV was associated with severe dysmenorrhoea, menorrhagia, and dyspareunia (p=0.016, 0.004, 0.010, respectively). Menorrhagia had an inverse association with endometriosis overall.

Conclusions

Endometriosis is more frequently associated with primary infertility and specific pelvic symptoms, particularly at advanced stages. Laparoscopy remains essential for accurate diagnosis and staging. Metrics

References

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endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

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