Endometriosis is a debilitating disease in women of child-bearing age.
Objective
To describe the pattern of presentation, stage of endometriosis and
biophysical profile of patients with endometriosis.
Method
A retrospective study of 61 consecutive infertile patients between June 2003
and November 2014.
Results
The means (±SD) of age (years) and of body mass index (BMI)
(kg/m2) of the patients were 34.1 (4.3) and 25.8 (5.0),
respectively. A relatively high percentage (43, 70.5%) of the women were in
the age range of 31-40 years; had normal BMI (27, 44.3%); were nulliparous
(53, 86.9%) and were of primary infertility (40, 65.6%). The mean (±SD) age
at menarche, of cycle length, of the duration of flow and of years trying to
conceive were 12.9 (1.7) years, 29.1 (2.7) days, 4.7 (1.1) days and 5.2
(3.8) years, respectively. A high proportion of them (37, 60.7%) presented
with severe endometriosis. The main symptoms at presentation was
dysmenorrhea (47, 73.8%). Of the 32 (52.5%) with associated utero-tubal
factor, 20 (62.5%) were in severe stage of endometriosis. Among women with
endometriosis, those with primary infertility were over three times more
likely to present with menorrhagia than those with secondary infertility (χ²
= 4.70; p value = 0.03; OR = 3.33; 95% CI = 1.10, 10.12). Only 3 (4.9%) had
diagnosis of endometriosis in first-degree relative. Dysmenorrhea was a
strong predictor of severe endometriosis.
Conclusions
There may be some trends in the biophysical profile of infertile women with
endometriosis which may influence diagnosis and management.
KennedySBergqvistAChapronCet al;ESHRE Special Interest Group for Endometriosis and Endometrium
Guideline Development Group. ESHRE guideline for the
diagnosis and treatment of endometriosis. Hum Reprod200520 (10)
26982704
2.
RockJAMarkhamSMPathogenesis of endometriosis.
Lancet1992340 (8830)
12641267
MacerMLTaylorHSEndometriosis and infertility: a review of the pathogenesis and
treatment of endometriosis-associated infertility.
Obstet Gynecol Clin North Am201239 (4)
535549
5.
BullettiCCocciaMEBattistoniSBoriniAEndometriosis and infertility. J Assist
Reprod Genet201027 (8)
441447
6.
VercelliniPTrespidiLDe GiorgiOCortesiIParazziniFCrosignaniPGEndometriosis and pelvic pain: relation to disease stage and
localization. Fertil Steril199665 (2)
299304
7.
Gruppo italiano per lo
studio dellendometriosi. Prevalence and anatomical
distribution of endometriosis in women with selected gynecological
conditions: results from a multi-centric Italian study. Hum Reprod19949 (6)
11581162
8.
BérubéSMarcouxSMaheuxRCanadian Collaborative Group on Endometriosis.
Characteristics related to the prevalence of minimal or mild
endometriosis in infertile women. Epidemiology19989 (5)
504510
9.
VesseyMPVillard-MackintoshLPainterREpidemiology of endometriosis in women attending family planning
clinics. BMJ1993306 (6871)
182184
10.
BellelisPDiasJAJrPodgaecSGonzalesMBaracatECAbrãoMSEpidemiological and clinical aspects of pelvic endometriosis–a
case series. Rev Assoc Med Bras (1992)201056 (4)
467471
11.
ACOG Committee on Practice
BulletinsGynecology. ACOG Practice Bulletin No. 51.
Chronic pelvic pain. Obstet Gynecol2004103 (3)
589605
12.
SomiglianaEViganoPParazziniFStoppelliSGiambattistaEVercelliniPAssociation between endometriosis and cancer: a comprehensive
review and a critical analysis of clinical and epidemiological
evidence. Gynecol Oncol2006101 (2)
331341
13.
BulunSEEndometriosis. N Engl J Med2009360 (3)
268279
14.
GiudiceLCClinical practice. Endometriosis. N Engl
J Med2010362 (25)
23892398
KyamaMCDHoogheTMDebrockSMachokiJChaiDCMwendaJMThe prevalence of endometriosis among African-American and
African-indigenous women. Gynecol Obstet
Invest200457 (1)
4042
17.
OtolorinEOOjengbedeOFalaseAOLaparoscopic evaluation of the tuboperitoneal factor in infertile
Nigerian women. Int J Gynaecol Obstet198725 (1)
4752
18.
OlubuyideIOAdebajoAOAdeleyeJASolankeTFMassive ascites associated with endometriosis in a Nigerian
African. Int J Gynaecol Obstet198827 (3)
439441
19.
OkunlolaMAAdekunleAOArowojoluAOOluwasolaAOIsolated umbilical endometriosisa rare finding.
Afr J Med Med Sci200231 (3)
281282
20.
ThacherTDNwanaEJKarshimaJAExtrapelvic endometriosis in Nigeria. Int
J Gyneacol Obstet199759 (1)
5758
21.
GuoSWWangYSources of heterogeneities in estimating the prevalence of
endometriosis in infertile and previously fertile women.
Fertil Steril200686 (6)
15841595
22.
MissmerSAHankinsonSESpiegelmanDBarbieriRLMarshallLMHunterDJIncidence of laparoscopically confirmed endometriosis by
demographic, anthropometric, and lifestyle factors.
Am J Epidemiol2004160 (8)
784796
23.
Calhaz-JorgeCMolBWNunesJCostaAPClinical predictive factors for endometriosis in a Portuguese
infertile population. Hum Reprod200419 (9)
21262131
24.
ParazziniFCiprianiSBraviF. A metaanalysis on alcohol consumption and risk of
endometriosis. Am J Obstet Gynecol2013209 (2)
106.e1106.e10
25.
TolossaFWBekeleMLPrevalence, impacts and medical managements of premenstrual
syndrome among female students: cross-sectional study in College of Health
Sciences, Mekelle University, Mekelle, northern Ethiopia.
BMC Womens Health201414 (1) 52
HedigerMLHartnettHJLouisGMAssociation of endometriosis with body size and
figure. Fertil Steril200584 (5)
13661374
29.
ArrudaMSPettaCAAbrãoMSBenetti-PintoCLTime elapsed from onset of symptoms to diagnosis of endometriosis
in a cohort study of Brazilian women. Hum
Reprod200318 (4)
756759
30.
VesseyMPVillard-MackintoshLPainterREpidemiology of endometriosis in women attending family planning
clinics. BMJ1993306 (6871)
182184
31.
HemmingsRRivardMOliveDL. Evaluation of risk factors associated with
endometriosis. Fertil Steril200481 (6)
15131521
32.
ShahDKCorreiaKFVitonisAFMissmerSABody size and endometriosis: results from 20 years of follow-up
within the Nurses Health Study II prospective cohort.
Hum Reprod201328 (7)
17831792
33.
ViganòPParazziniFSomiglianaEVercelliniPEndometriosis: epidemiology and aetiological
factors. Best Pract Res Clin Obstet
Gynaecol200418 (2)
177200
34.
BattREMitwallyMFMEndometriosis from thelarche to midteens: pathogenesis and
prognosis, prevention and pedagogy. J Pediatr
Adolesc Gynecol200316 (6)
337347
35.
Buck LouisGMHedigerMLPeñaJBIntrauterine exposures and risk of endometriosis.
Hum Reprod200722 (12)
32323236
36.
NnoahamKEWebsterPKumbangJKennedySHZondervanKTIs early age at menarche a risk factor for endometriosis? A
systematic review and meta-analysis of case-control studies.
Fertil Steril201298 (3)
702712.e6
37.
TreloarSABellTANagleCMPurdieDMGreenACEarly menstrual characteristics associated with subsequent
diagnosis of endometriosis. Am J Obstet
Gynecol2010202 (6)
534.e1534.e6
38.
Garcia-VelascoJASomiglianaEManagement of endometriomas in women requiring IVF: to touch or
not to touch. Hum Reprod200924 (3) 496501
Published online December 4, 2008.
39.
MacerMLTaylorHSEndometriosis and infertility: a review of the pathogenesis and
treatment of endometriosis-associated infertility.
Obstet Gynecol Clin North Am201239 (4)
535549
40.
BarriPNCoroleuBTurRBarri-SoldevilaPNRodríguezIEndometriosis-associated infertility: surgery and IVF, a
comprehensive therapeutic approach. Reprod Biomed
Online201021 (2)
179185
41.
LesseyBAMedical management of endometriosis and
infertility. Fertil Steril200073 (6)
10891096
42.
PaskulinDDCunha-FilhoJSSouzaCABortoliniMCHainautPAshton-ProllaPTP53 PIN3 and PEX4 polymorphisms and infertility associated with
endometriosis or with post-in vitro fertilization implantation
failure. Cell Death Dis20123 (9) e392
43.
OpøienHKFedorcsakPOmlandAK. In vitro fertilization is a successful treatment in
endometriosis-associated infertility. Fertil
Steril201297 (4)
912918
44.
DongXLiaoXWangRZhangHThe impact of endometriosis on IVF/ICSI outcomes.
Int J Clin Exp Pathol20136 (9)
19111918
45.
MatalliotakisIMCakmakHFragouliYGGoumenouAGMahutteNGAriciAEpidemiological characteristics in women with and without
endometriosis in the Yale series. Arch Gynecol
Obstet2008277 (5)
389393
46.
Sangi-HaghpeykarHPoindexterANIII.Epidemiology of endometriosis among parous women.
Obstet Gynecol199585 (6)
983992
WeiMChengYBuHZhaoYZhaoWLength of Menstrual Cycle and Risk of Endometriosis: A
Meta-Analysis of 11 Case-Control Studies. Medicine
(Baltimore)201695 (9) e2922
49.
MoiniAMalekzadehFAmirchaghmaghiE. Risk factors associated with endometriosis among
infertile Iranian women. Arch Med Sci20139 (3)
506514
50.
CramerDWWilsonEStillmanRJ. The relation of endometriosis to menstrual
characteristics, smoking, and exercise.
JAMA1986255 (14)
19041908
51.
VercelliniPDe GiorgiOAimiGPanazzaSUgliettiACrosignaniPGMenstrual characteristics in women with and without
endometriosis. Obstet Gynecol199790 (2)
264268
52.
DonnezJVan LangendoncktACasanas-RouxF. Current thinking on the pathogenesis of
endometriosis. Gynecol Obstet Invest200254Suppl 15258 discussion 59-62.
HughesdonPEThe structure of endometrial cysts of the ovary.
J Obstet Gynaecol Br Emp195764 (4)
481487
60.
BrosensIAPuttemansPJDeprestJThe endoscopic localization of endometrial implants in the
ovarian chocolate cyst. Fertil Steril199461 (6)
10341038
61.
LeeEJKwonHCJooHJSuhJHFleischerACDiagnosis of ovarian torsion with color Doppler sonography:
depiction of twisted vascular pedicle. J Ultrasound
Med199817 (2)
8389
62.
WentzensenNPooleEMTrabertB. Ovarian cancer risk factors by histologic subtype: an
analysis from the ovarian cancer cohort consortium.
J Clin Oncol201634 (24)
28882898
