Prevalence; Characteristics and Management of Endometriosis Amongst Infertile Women: A One Year Retrospective Study.
BACKGROUND
Endometriosis appears to affect every aspect of a women's reproductive system resulting in infertility and spontaneous pregnancy loss. This study aims to find out the prevalence & clinical characteristics of endometriosis amongst infertile women.


METHODS
A Hospital based retrospective study over a period of one year.


METHODS
It is a retrospective study conducted in the gynaecology department in Institute of Kidney Diseases & Research Centre; Ahmedabad from April 2012 to March 2013 amongst women with a primary complaint of infertility (Primary/Secondary).A total of 372 patients underwent diagnostic hysterolaparoscopy and of these 180 patients who had laparoscopic evidence of endometriosis was included in the study. All of these patients and their findings were analysed with respect to the clinical signs and symptoms. The outcome after appropriate management was analysed in subsequent follow up.


METHODS
All collected data was entered into the SPSS version 20. Categorical data are expressed in frequency or percentage. Chi-Square test and Fisher-Exact test has been performed to carry out p-value for categorical data. P-value <0.05 shows statistically significant difference.


RESULTS
The frequency of endometriosis among women with infertility subjected to diagnostic hysterolaparoscopy was found to be 48.38%. Statistical significant association with severity of disease was associated with symptoms like dysmenorrhea, chronic pelvic pain, restricted uterine mobility and adnexal tenderness. (p <0.01) Ultrasound finding of endometrioma with ground glas appearance also had statistical significant association with staging of disease (p <0.01).


CONCLUSIONS
Endometriosis amongst infertile women is increasingly being detected due to greater use of laparoscopy in evaluation of infertility.Though most signs do not correlate with severity of disease however the presence of restricted uterine mobility, adnexal tenderness & chronic pelvic pain should always raise the suspicion of endometriosis. Laparoscopy remains the gold standard for diagnosing and staging endometriosis.
Professor and HOD, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Vineet V
VV
Mishra
Clinical Fellow, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Rashmi A
RA
Gaddagi
Associate Professor, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Rohina
R
Aggarwal
Assistant Professor, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Sumesh
S
Choudhary
Clinical Fellow, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Urmila
U
Sharma
Clinical Fellow, Department of Obstetrics and Gynaecology, Institute of Kidney Diseases and Research Centre , Ahmedabad, India .
Ushma
U
Patel
Infertility; Laparoscopy; Uterine cavity