Department of Obstetrics and Gynecology and Reproductive Medicine, Hopital Foch-Faculté de Medicine Paris Ouest (UVSQ), Suresnes, France; Faculte de Medicine Paris Ouest, Suresnes, France.
Department of Obstetrics and Gynecology and Reproductive Medicine, University Hospital, Lausanne, Switzerland.
Fertil Steril. 2022 Jul;118(1):29-33. doi: 10.1016/j.fertnstert.2022.03.015. Epub 2022 May 12.
Endometriosis was classically diagnosed during diagnostic laparoscopies, which used to be routinely performed up until a decade ago or so. This practice fitted with the long-held belief that surgery was the gold standard for diagnosing endometriosis. Today, the abandon of routine diagnostic laparoscopies-in favor of assisted reproductive technology-first therapeutic approaches-has created a void for diagnosing endometriosis. Modern-day imaging techniques-ultrasound and magnetic resonance imaging-when used with a systematic approach have offered a reliable replacement option for diagnosing endometriosis. In infertility, endometriosis should be identified or excluded on the basis of past history or confirmation or exclusion suspicion on the basis of history and/or physical examination.
子宫内膜异位症经典的诊断方法是在诊断性腹腔镜检查中进行,这种方法在十年前左右还被常规使用。这种做法符合长期以来的观点,即手术是诊断子宫内膜异位症的金标准。如今,为了支持辅助生殖技术(首先是治疗方法)而放弃常规诊断性腹腔镜检查,导致了诊断子宫内膜异位症的空缺。现代影像学技术——超声和磁共振成像——如果采用系统的方法,是诊断子宫内膜异位症的可靠替代选择。在不孕症中,应根据既往病史或病史和/或体格检查的基础上确认或排除可疑情况来确定或排除子宫内膜异位症的存在。