DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20163858

Cohort study of endometriosis in south Indian district

Mohan Rajeswari, Thirunavukarasu Ramanidevi, Balamuthu Kadalmani

Abstract


Background: Endometriosis is a life threatening problem in reproductive age women. The aim of the present study is to correlate the association of endometriosis with primary and secondary infertility pertaining to age distribution, staging of the disease based on AFS scoring by laparoscopy.

Methods: A retrospective approach of using a questionnaire method to collect the case history of women suffering from endometriosis at Ramakrishna Medical centre, Trichy during the period of January 2012 – June 2015 was carried out. Women having endometriosis with infertility problem was an inclusion criteria whereas, women without endometriosis are excluded from the study, a total of 195 women were subjected to incorporate various parameter and verdict the inference of this study. In addition, other parameters such as the Incidence of endometriosis among patients subjected to laparoscopy, age of the patients, type of infertility, also the stages of endometriosis based upon the laparoscopic findings were recorded. Further the analysis of clinical data was carried out using MS excel and SPSS version-16.

Results: Incidence of endometriosis among infertility patients who have undergone laparoscopy was 195/569 (34.2%), Age group at which highest incidence observed is between 26-30 years (37%). Between the ages of 21 to 25 years incidence of endometriosis was 18%, 21-30 years which is the optimum age for reproduction the incidence was 55 %. Primary infertility was seen in 84.5% subjects. Some association was seen in Stages of endometriosis and laparoscopy findings whereas there was no association between the age and stages of the disease. PCOS, fibroids and Mullerian anamolies were observed to be associated with endometriosis.

Conclusions: This study concludes that endometriosis predominantly affects the women of reproductive age group and causes primary infertility in majority of the patients. A laparoscopic finding marks as a standard tool in diagnosis and treatment of endometriosis which would be reported by association between endometriosis stage with age of women and laparoscopic findings.

Keywords


Age, Endometriosis, Epidemiology, Infertility, Laparoscopic findings

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References


Balasch J, Creus M, Fabregues F, Carmona F, Ordi J, Martinez-Roman S et al. Visible and non-visible endometriosis at laparoscopy in fertile and infertile women and in patients with chronic pelvic pain: a prospective study. Hum Reprod. 1996;11:387-91.

Farquhar CM. Extracts from the "clinical evidence". Endometriosis. BMJ. 2000;320:1449-52.

Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL. Time elapsed from the onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod. 2003;18:756-9.

Vinatier D, Orazi G, Cosson M, Dofour P. Theories of endometriosis. Eur J Obstet Gynecol Reprod Biol. 2001;96:21-34.

Stefansson H, Geirsson RT, Steinthorsdottir V, Jonsson H, Manolescu A, Kong A, et al. Genetic factors contribute to the risk of developing endometriosis. Hum Reprod. 2002;17:555-9.

Hemmings R, Rivard M, Olive DL, Poliquin-Fleury J, Gagné D, Hugo P, et al. Evaluation of risk factors associated with endometriosis. Fertil Steril. 2004;81:1513-21.

Kashima K, Ishimaru T, Okamura H, Suginami H, Ikuma K, Muramaki T, et al. Familial risk among Japanese patients with endometriosis. Int J Gynecol Obstet. 2004;84:61-4.

Heilier JF, Donnez J, Nackers F, Rousseau R, Verougstraete V, Rosenkranz K, et al. Environmental and host-associated risk factors in endometriosis and deep endometriotic nodules: a matched case-control study. Environ Res. 2007;103:121-9.

Petta CA, Matos AM, Bahamondes L, Faúndes D. Current practice in the management of symptoms of endometriosis: a survey of Brazilian gynecolo- gists. Rev Assoc Med Bras. 2007;53:525-9.

Gao X, Outley J, Botteman M, Spalding J, Simon JA, Pashos CL. Economic burden of endometriosis. Fertil Steril. 2006;86:1561-72.

Fernandez I, Reid C, Dziurawiec S. Living with endometriosis: the perspective of male partners. J Psychosom Res. 2006;61:433-8.

Jones GL, Kennedy SH, Jenkinson C. Health-related quality of life measurement in women with common benign gynecologic conditions: a systematic review. Am J Obstet Gynecol. 2002;187:501-11.

Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, et al. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005;20:2698-704.

Hornstein MD, Gleason RE, Orav J, Haas ST, Friedman AJ, Rein MS et al. The reproducibility of the revised American Fertility Society classification of endometriosis. FertilSteril. 1993;59:1015-21.

Mehmud G, Akhtar T, Sadia S. Endometriosis: frequency and correlation between symptomatology and disease stage. J Coll Physicians Surg Pak. 2007;17:199-202.

Khawaja UB, Khawaja AA, Gowani SA, Shoukat S, Ejaz S, Ali FN, et al. Frequency of endometriosis among infertile women and association of clinical signs and symptoms with the Laparoscopic staging of Endometriosis. J Pak Med Assoc. 2009;59:30-4.

Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod. 1991;6:544-9.

Prevalence and anatomical distribution of endometriosis in women with selected gynaecological conditions: results from a multicentric Italian study. Gruppoitaliano per lo studio dell'endometriosi. Hum Reprod. 1994;9:1158-62.

Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients. Hum Reprod. 2007;22:266-71.

Mokhtar S, Hassan HA, Mahdy N, Elkhwsky F, Shehata G. Risk factors for primary and secondary female infertility in Alexandria: A hospital based case control study. J Med Res Institute. 2006;27(4):255-61.

Maheshwari A, Hamilton M, Bhattacharya S. Effect of female age on the diagnostic categories of infertility. Hum Reprod. 2008;23(3):538-42.

Ferrero S, Anserini P, Remorgida V, Ragni N. Body mass index in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2005;121:94-8.

Hediger ML, Hartnett HJ, Louis GM. Association of endometriosis with body size and figure. Fertil Steril. 2005;84:1366-74.

Egger H, Weigmann P. Clinical and surgical aspects of ovarian endometriotic cysts. Arch Gynecol. 1982;233(1):37-45.