Endometriosis as a Cause of Infertility from Iatrogenic Aetiology. An African Perspective

Endometriosis is one of the proven causes of infertility in developed countries but it has not been widely reported as such in the tropics. The incidence of endometriosis as a cause of infertility in Nigerian females based on gynaecological practice at Ife University Teaching Hospital Complex (IUTHC), Ile-Ife, Nigeria was investigated. A retrospective study from August 1981 to May 1986 on infertility cases that had laparoscopy was carried out. Of these cases that had laparoscopy, 104/130 (80%) were for infertility, 10/130 (7.7%) for pelvic masses, 2/130 (1.5%) for suspected ectopic pregnancy, 4/130 (3%) for pelvic inflammatory disease, 7/130 (5.4%) for bilateral tubal ligation, 1/130 (0.77%) for ambiguous genitalia and 2/130 (1.54%) for suspected endometriosis. Paradoxically, the 3 cases being reported were infertile females who developed endometriosis after genital tract surgery. Our study confirms the rarity of endometriosis as an aetiological factor in infertility among black Africans. The reproductive performance of these reported cases is the subject of further investigation.