OP11.02: Uterine junctional zone (JZ) in infertile and fertile patients with and without pelvic endometriosis: a three‐dimensional transvaginal ultrasound (3TVS) study

The aim of this study was to assess the efficacy of 3D TVS to detect morphological alterations of JZ in infertile patients affected by pelvic endometriosis and to correlate the findings to the laparoscopic stage of endometriosis. We evaluated JZ on the uterine coronal section obtained by 3D volume acquisition in patients scheduled for laparoscopy. Measurements of thickness, infiltration and disruption of the JZ were compared in patients with infertility or pelvic pain with and without endometriosis documented at laparoscopy and histology. Four groups of patients were considered for statistical analysis, patients with infertility or pain and with or without endometriosis. Furthermore JZ features were correlated with surgical stage of endometriosis. The mean age of the 82 patients in this study was 33.9 and did not differ among the 4 groups. Infertility was documented in 59 patients and of these 48 had endometriosis. Of the 23 fertile patients endometriosis was seen at laparoscopy in 11patients. The JZ maximum thickness in patients with endometriosis was significantly greater than in patients without endometriosis (6.5 ± 1.9 vs. 4.8 ± 1.0 mm). No difference in JZ features were observed between infertile and fertile patients. JZ alterations are not stage related, also patients with minimal pelvic endometriosis showed thicker JZ compared to patients without endometriosis. 3D assessment of the JZ may be useful in identifying those women affected by endometriosis with or without infertility when there are no other sonographic signs of the disease. This study suggests that alterations in the JZ is related to endometriosis and not to infertility only.