Women who are not exposed to spermatozoa and infertile women have similar rates of stage I endometriosis.
OBJECTIVE
To compare the prevalence of endometriosis and its different stages in infertile women and women not exposed to spermatozoa.


METHODS
Prospective study.


METHODS
Artificial insemination donor program at a university hospital.


METHODS
One hundred fifty women unable to conceive because they had not been exposed to spermatozoa (134 with azoospermic partner, 10 with an HIV-positive partner, and 6 without a male partner). Controls were 750 women in infertile couples in which the male partner had normal sperm.


METHODS
Laparoscopy was systematically performed in a blinded manner in both groups as part of the infertility work-up.


METHODS
Diagnosis of endometriosis.


RESULTS
In unexposed women and controls, the prevalence of endometriosis was similar (32% and 34.5%). Rates of stage I disease were also similar in both groups (26% and 19.3%). There was a significant trend toward higher stages of endometriosis in infertile women (stage II disease, 3.3% vs. 5.7%; stage III disease, 1.3% vs. 3.1%; stage IV disease, 1.3% vs. 6.4%). Endometriosis was not associated with the few demographic characteristics that differed between groups.


CONCLUSIONS
From an epidemiologic point of view, stage I endometriosis is not more common in infertile women than in unselected women. However, stage II to IV endometriosis was more frequent in infertile women. Whereas a relation between stage I endometriosis and infertility seems unlikely, the relation between stages II to IV endometriosis and infertility seems possible.
Matorras
R
R
Human Reproduction Unit, Department of Obstetrics and Gynecology, Hospital de las Cruces, País Vasco University, Baracaldo, Vizcaya, Spain. matorras@hcru.osakidetza.net
Rodríguez
F
F
Pijoan
J I
JI
Etxanojauregui
A
A
Neyro
J L
JL
Elorriaga
M A
MA
Rodríguez-Escudero
F J
FJ
D000328:Adult; D004715:Endometriosis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000473:pathology*; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012746:Sexual Abstinence; D013030:Spain / Q000453:epidemiology