Epidemiology of endometriosis-associated infertility.

To explain the great discrepancy between the prevalence estimates for endometriosis in the literature, a series of operations was studied from a combined patient population derived from a 21-physician collaborative. The reported discrepancy appears to have to do more with operative indications and technique than with an actual increase in the prevalence of endometriosis over time. The least-biased estimate for the overall prevalence of endometriosis in reproductive-age women is about 10% on the basis of a study of women operated on for symptoms other than those associated with endometriosis. Accepted criteria for causality applied to the endometriosis literature failed to demonstrate an association between endometriosis and infertility.