P-73: Infertility Is More Prevalent among Cases with Peritoneal Involvement Endometriosis in Comparison to Those with Ovarian Involvement
We intended to determine the incidence of endometriosis at diagnostic laparoscopy for infertility problem and pelvic pain and/or cyst. In addition we aimed to evaluate symptoms, different stages and locations of endometriosis in fertile or infertile endometriosis patients.
Materials and methods
This observational cross-sectional study was performed in the Department of Obstetrics and Gynecology, Vali-e-Asr Hospital, Tehran, Iran and the Surgery Unit of Royan Institute, Tehran, Iran, between January 2012 and January 2013. All cases were categorized as early (stages I and II) or late (stages III and IV) stage into fertile and infertile endometriosis groups. The extent of endometriosis was divided into peritoneal, ovarian, and ovarian+peritoneal. Endometriosis patients’ symptoms were assessed and compared among those different groups.
Four hundred and thirteen women were referred for diagnostic laparoscopy, among which 383 patients were categorized into infertility and 30 patients into pelvic pain and/or cyst groups. The incidences of endometriosis at the diagnostic laparoscopic for infertility or pelvic pain and/or cyst are comparable to each other (50.3% vs. 46.6%). The frequencies of dysmenorrhea or non-cyclic pelvic pain were similar between end-stage (P=0.1) and late stage endometriosis patients (P=0.2). Also the peritoneal endometriosis was more significant among infertile women than those in fertile women (P= 0.01). In addition dysmenorrhea, noncyclic pelvic pain and premenstrual spotting were more prevalent among cases with ovarian+peritoneal endometriosis lesions.
Our results demonstrated no correlation between the frequency of dysmenorrhea or non-cyclic pelvic pain and endometriosis stages, although these pain symptoms were significantly prevalent in cases with both ovarian and peritoneal endometriotic implants. Infertility was more prevalent among peritoneal endometriosis cases in compared with ovarian endometriosis. Further studies are needed to clarify the location of endometriotic implants in order to predict the chance of fertility in endometriosis cases.