Frequency of Endometriosis Detected on Diagnostic Laparoscopy Among Infertile Women – A Cross-Sectional Study

Open Access

Abstract

Background: Endometriosis, the presence of endometrial-like tissue outside the uterus, is common in reproductive-age women and contributes to infertility, pain, and reduced quality of life. Diagnosis relies on laparoscopy, though subtle lesions may be missed. Prevalence in infertile women varies globally (11.5–55%) and in Bangladesh (22–46%). This study aimed to assess the prevalence of endometriosis in infertile women undergoing diagnostic laparoscopy and its association with clinical symptoms. Methods & Materials: This cross-sectional study at BIRDEM General Hospital-2, Dhaka (July 2020–June 2021), included 115 women aged 20–40 years with primary or secondary infertility, excluding male-factor infertility, chromosomal disorders, or primary amenorrhea. Participants underwent clinical evaluation and diagnostic laparoscopy, with endometriosis staged by r‑ASRM. Demographic and clinical data were recorded. The primary outcome was the frequency of endometriosis. Ethical approval and informed consent were obtained. Results: The study included 115 infertile women undergoing diagnostic laparoscopy, mostly aged 26–35 years, from middle socio-economic backgrounds, predominantly housewives, and largely rural residents. Primary infertility was more common, with delayed presentation for evaluation. Endometriosis was detected in 38.3% of women. Among affected women, dysmenorrhea (68.2%) and chronic pelvic pain (61.4%) were most frequent, while dyschezia and urinary symptoms were less common, and some women were asymptomatic. Regarding severity, Stage IV (severe) disease was most common (47.7%), followed by Stage I and III (20.5% each), and Stage II (11.4%), indicating a predominance of advanced-stage endometriosis. Conclusion: Endometriosis significantly contributes to infertility, commonly presenting with pelvic pain. Advanced-stage disease is frequent, highlighting the need for early recognition and timely diagnostic laparoscopy for effective management.