Aliani Fatemeh, Ashrafi Mahnaz, Arabipoor Arezoo, Shahrokh-Tehraninejad Ensieh, Jahanian Sadatmahalleh Shahideh, Akhond Mohammad Reza
a Obstetrics and Gynecology Department, Faculty of Medicine , Tehran University of Medical Science , Tehran , Iran.
b Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran.
J Obstet Gynaecol. 2018 May;38(4):536-542. doi: 10.1080/01443615.2017.1374933. Epub 2018 Feb 1.
This cross-sectional study aimed to assess the prevalence of endometriosis in women who were referred for Diagnostic Laparoscopy Unit due to infertility or pelvic pain between January 2012 and January 2013 and compare the symptoms and laparoscopic signs among the three groups according to the fertility status. Four hundred and thirteen women were evaluated; of these, 383 patients for infertility and 30 patients for pelvic pain and/or cyst. Endometriosis symptoms were compared between fertile and infertile women with primary and secondary infertility. There was no statistically significant difference in the overall prevalence of endometriosis between the three study groups (52.9%, 45% and 40.7%, respectively, in primary, secondary infertile and fertile women). The endometriosis stage was categorised as early- (I and II) or late- (III and IV) stages and the extent of endometriosis was divided into peritoneal, ovarian and ovarian coexisting with peritoneal. There is no relationship between the frequency of dysmenorrhoea or non-cyclic pelvic pain and the disease stage; although these pain symptoms are significantly more prevalent in cases with both ovarian and peritoneal endometriotic implants. Infertility was more prevalent among the patients with peritoneal endometriosis in comparison to the ones with ovarian endometriosis. Further studies with a larger sample size are required to confirm these findings. Impact statement What is already known on this subject? Few studies have been done in this area and only one study compared the localisation of endometriosis lesions between fertile and infertile endometriosis cases; however, more study is needed to confirm their results. What the results of this study add? A possible relationship between localisation of endometriosis involvement and infertility was found in the present study in agreement to result of a previous study performance in this area. Although the present study includes a greater number of cases than that of the previous reported study, further studies with a larger sample size are required for the confirmation or refusal of this finding. What are the implications of these findings for clinical practice and/or further research? The results of this study could have clinical application in the consultation and decision-making in infertile women with an endometriosis diagnosis.
这项横断面研究旨在评估2012年1月至2013年1月期间因不孕或盆腔疼痛而被转诊至诊断性腹腔镜科室的女性子宫内膜异位症的患病率，并根据生育状况比较三组患者的症状和腹腔镜检查体征。共评估了413名女性；其中，383例为不孕症患者，30例为盆腔疼痛和/或囊肿患者。对原发性和继发性不孕的育龄期和不孕女性的子宫内膜异位症症状进行了比较。三个研究组之间子宫内膜异位症的总体患病率无统计学显著差异（原发性不孕女性、继发性不孕女性和育龄期女性分别为52.9%、45%和40.7%）。子宫内膜异位症分期分为早期（I期和II期）或晚期（III期和IV期），子宫内膜异位症的范围分为腹膜型、卵巢型以及卵巢合并腹膜型。痛经或非周期性盆腔疼痛的频率与疾病分期之间没有关系；尽管这些疼痛症状在卵巢和腹膜均有子宫内膜异位植入的病例中更为普遍。与卵巢子宫内膜异位症患者相比，腹膜子宫内膜异位症患者的不孕症更为普遍。需要进行更大样本量的进一步研究来证实这些发现。影响声明关于该主题已知的信息有哪些？该领域的研究较少，仅有一项研究比较了育龄期和不孕子宫内膜异位症病例中子宫内膜异位症病变的定位；然而，需要更多研究来证实其结果。本研究的结果补充了什么？本研究发现子宫内膜异位症累及部位与不孕症之间可能存在关联，这与该领域之前的一项研究结果一致。尽管本研究纳入的病例数比之前报道的研究更多，但仍需要更大样本量的进一步研究来证实或否定这一发现。这些发现对临床实践和/或进一步研究有何意义？本研究结果可能在对诊断为子宫内膜异位症的不孕女性进行咨询和决策时具有临床应用价值。
