Strathy J H, Molgaard C A, Coulam C B, Melton L J
Fertil Steril. 1982 Dec;38(6):667-72. doi: 10.1016/s0015-0282(16)46691-4.
To test the widely accepted--but not well-supported--impression that endometriosis and infertility are associated, we compared the prevalence of endometriosis visualized at laparoscopy in 100 patients being evaluated for infertility and in 200 fertile control subjects (two age-matched to each patient) undergoing tubal ligation. The extent of endometriosis and adhesions noted in the operative reports was classified according to the system proposed by The American Fertility Society. Endometriosis was found in 21 of the 100 infertile patients--mild in 11, moderate in 8, severe in 2. It was found in 4 (2%) of the 200 controls and was mild in all 4. Thus, endometriosis is more often present, and more often severe, among infertile patients. The risk of infertility was estimated to be almost 20 times greater with endometriosis than without. These data support the clinical impression that an association exists.
为了验证子宫内膜异位症与不孕症相关这一被广泛接受但证据并不充分的观点，我们比较了100名因不孕症接受评估的患者和200名接受输卵管结扎的可育对照者（与每名患者年龄匹配的两人）腹腔镜检查时可视化的子宫内膜异位症患病率。根据美国生育协会提出的系统，对手术报告中记录的子宫内膜异位症和粘连程度进行分类。100名不孕患者中有21例发现子宫内膜异位症——轻度11例，中度8例，重度2例。200名对照者中有4例（2%）发现有子宫内膜异位症，且均为轻度。因此，不孕患者中子宫内膜异位症更常见，且病情更严重。据估计，患有子宫内膜异位症的患者不孕风险比未患该病的患者高近20倍。这些数据支持了两者之间存在关联的临床观点。
