Prevalence Of Endometriosis In Women Research Articles

Prevalence, Surgical, and Medical Management of Patients with Endometriosis amongst Indian Women

Objective: This study aims to determine the prevalence of endometriosis in women in South India, the epidemiological factors involved, and evaluate the symptomatic burden associated with it. Design: A large-scale Hospital-based study was conducted among women of reproductive age (16 to 44 years) in the state of Telangana between March 2018 and March 2023. A randomized multi-stage stratified sampling method was adopted and included 2,400 women who were screened using a validated structured questionnaire. Patients presenting with symptoms indicative of endometriosis underwent additional assessment using abdominal ultrasonography (AUS) and serum cancer antigen 125 (CA125) tests. For confirmation, laparoscopy was offered to the patients who consented. Patients who declined laparoscopy were given the option of undergoing magnetic resonance imaging (MRI) instead. Results: Among 2,400 women who participated, 60 women have been diagnosed with endometriosis during the 5-year study period. The prevalence of endometriosis was found to be 2.5%. The mean age of participants was 15.2 ± 3.5 years and the mean age at menarche was found to be 12.9 ± 1.1 years. Out of 60 participants diagnosed with endometriosis 30% (n = 18) experienced irregular menstrual cycles. Approximately 33.3% (n = 20) of the women reported experiencing Dysmenorrhea, with 28.4% (n = 17) complaining of dyspareunia. Among the cases with menstrual pain, exhibited ultrasound findings suggestive of endometriosis, with elevated CA125 levels observed in 45% (n = 27) of these cases. All 60 patients who consented to laparoscopic confirmation, exhibited positive histo-pathological evidence of endometriosis. The prevalence of endometriosis is found to be significant in women of reproductive age group and found to be associated with high rates of infertility in 15 (25%) patients. The results of this study showed that the prevalence of endometriosis is found to be 2.5% which is similar to the other studies reported. The severity of endometriosis during laparoscopy was assessed using the rAFS staging system, revealing rates of 55% and 45% for disease in Stages I & II, Stages III, & IV, respectively. Conclusion: Our study concludes that endometriosis predominantly affects women in the reproductive age group and is often associated with primary infertility. The laparoscopic findings are identified as a standard tool for both diagnosis and treatment of endometriosis.

The potential of survivin as a non-invasive diagnostic marker for endometriosis in patients with type 1 diabetes mellitus

BACKGROUND: According to international data, about 5-10% of women of reproductive age suffer from this disease, while in women with chronic pelvic pain or infertility the incidence ranges from 35% to 50%. At the same time, women of reproductive age diagnosed with diabetes mellitus type 1 may also suffer from endometriosis, but asymptomatic or atypical in the initial stages of the disease, which varies considerably in duration, may be the cause of untimely diagnosis. Existing diagnostic methods in the form of bimanual examination, ultrasound, MRI, laparoscopic surgery, and even histologic verification do not allow to exclude with certainty the presence of the disease.
 AIM: The aim of this study was to investigate the prevalence and characteristics of endometriosis among patients with type 1 diabetes mellitus to develop a diagnostic prognostic model.
 MATERIALS AND METHODS: We carried out a retrospective analysis of medical records from the Gynecological Unit of the Second Department of Gynecology and Endocrinology and the Scientific Advisory Department of D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductive Medicine, St. Petersburg, Russia for the period of 2010–2021. The study cohort included cases of endometriosis in patients with type 1 diabetes mellitus recorded in inpatient or outpatient medical histories. Clinical characteristics of the prevalence of endometriosis in women with type 1 diabetes mellitus were based on an analysis of 2316 medical records in this patient group. The prospective cohort of the case-control study included 137 patients and involved the evaluation of survivin levels in serum on days 5–7 of the menstrual cycle in four study groups: type 1 diabetes mellitus in combination with endometriosis, endometriosis, type 1 diabetes mellitus, and healthy women of reproductive age. Additionally, we examined the gynecological history of patients. Statistical processing of the data obtained and predictive modeling were performed using a binary logistic regression analysis.
 RESULTS: The prevalence of endometriosis among patients with type 1 diabetes mellitus was 1.11%. Risk indicators for the presence of endometriosis were determined based on risk factor values for patients with or without type 1 diabetes mellitus. Patient groups with a probability of having endometriosis exceeding 50% were identified, requiring diagnostic and therapeutic measures aimed at timely initiation of therapy.
 CONCLUSIONS: Predicting the likelihood of endometriosis presence will enable timely preventive and therapeutic measures aimed at improving the patient’s quality of life.

Effect of Administration of Red Fruit (Pandanus conoideus L.) Extract in TNF-α, Microvessels Density Expression and Endometriosis Implant Area in Endometriosis Mice Model

Introduction: The prevalence of endometriosis in women of reproductive age was still high. A previous study showed that the red fruit (Pandanus conoideus L.) extract consisted of alpha-tocopherol and beta carotene as antioxidants that could potentially be an alternative treatment in endometriosis. This study aimed to determine the effect of Red Fruit Extract Administration on the expression of TNF-α, microvessels density (MVD), and the area of endometriosis implant in endometriosis mice model. Methods: This was an experimental study with a randomized post-test control group design only applied to the endometriosis mice model and conducted in the Veterinary Faculty of Medicine Airlangga University, Surabaya. Twenty-eight endometriosis model mice were randomly divided into two groups. The control group (K) received CMC Na 5% for 14 days, and the treatment group (P) was given Red Fruit extract of 0,05 ml/day for 14 days. After day 28, mice were sacrificed, and immunohistochemical analysis was performed for TNF-α, microvessel density (MVD), and measured for endometriosis implant area. A T-test was used to analyze the comparison between groups. Results: Mean TNF-α, microvessel density, area of endometriosis implant in treatment group were 1,56±0,87, 1,26±0,48, 13,24±4,08, respectively. There was a statistically significant difference in TNF-α expression, MVD development, and area of endometriosis implant between the treatment and control groups (p<0.05). Conclusion: There was decreased expression of TNF-α, development of microvessel density, and area of endometriosis implant in endometriosis mice model given red fruit extract and proved to have potential effect as endometriosis therapy.

Prevalence of endometriosis in women undergoing laparoscopic surgery for various gynaecological indications at a Jordanian referral centre: gaining insight into the epidemiology of an important women's health problem

BackgroundEndometriosis is a considerable health challenge for women of reproductive age. Information about its prevalence in the Jordanian population is sparse. The objective of this research was to evaluate the presence of endometriosis in gynaecological patients undergoing laparoscopic surgery for various indications and to correlate the finding of endometriosis with variables, including patient demographics, obstetric history, type, and indication of laparoscopic procedure.MethodsA retrospective cohort study involving 460 women who underwent different laparoscopic procedures for a variety of indications was conducted in the Department of Obstetrics and Gynaecology in Jordan University Hospital, a tertiary referral hospital in Jordan, between January 2015 and September 2020.ResultsThe prevalence of endometriosis in this patient group was higher than that of the general population (13.7% vs. 2.5%), and the mean age at diagnosis (31.9 years) was younger than the general population's age of peak incidence (35–45 years). It was significantly higher in women with lower numbers of pregnancies (p = 0.01) and a lower number of Caesarean sections (p = 0.05) and in those where the indication for surgery was related to decreased fertility or pelvic pain (p = 0.02). Women with high parity or where the surgery's indication suggested normal fertility, such as family planning, were less likely to have endometriosis.ConclusionTo our knowledge, this is the first Jordanian study to assess the prevalence of endometriosis in women undergoing gynaecological laparoscopy. This study suggests that the epidemiology of endometriosis in this region follows similar trends to what has been previously documented in international literature, while emphasizing the need for further research into this important women's health issue in this part of the world.

A systematic review on the prevalence of endometriosis in women.

Background & objectives:Endometriosis is one of the causes of female infertility, but the prevalence of endometriosis is not exactly known. We conducted a systematic review and meta-analysis to provide an estimate of the prevalence of endometriosis in women considering the stage of disease, diagnostic method, geographical distribution, clinical symptoms and sample size.Methods:MEDLINE, Web of Science, Google Scholar, Scopus and Cumulative Index of Nursing and Allied Health were searched to identify peer-reviewed studies published from January 1990 to December 2018 reporting the prevalence of endometriosis. Relevant additional articles were identified from the lists of the retrieved articles. Studies with cross-sectional design were included in the meta-analysis.Results:The overall prevalence of endometriosis was 18 per cent [95% confidence interval (CI): 16-20] and the prevalence of endometriosis by stage ranged from two per cent (95% CI: 1-4) for stage 4 to 20 per cent (95% CI: 11-28) for stage 1. The prevalence levels of endometriosis in women with infertility, chronic pelvic pain and asymptomatic were 31 (95% CI: 15-48), 42 (95% CI: 25-58) and 23 per cent (95% CI: 19-26), respectively.Interpretation & conclusions:The results of this study showed that the prevalence of endometriosis in developing countries was high. Future studies are needed to explore other factors affecting the prevalence of endometriosis worldwide, which may help develop future prevention programmes.

Coincidence of uterine malformations and endometriosis: a clinically relevant problem?

It is suspected that uterine malformations and endometriosis have a high coincidence. Furthermore, it is expected that obstructive uterine malformations are significantly higher affected than non-obstructive malformations. The correlation between endometriosis and uterine malformations may be due to increased retrograde menstruation, which would explain a higher coincidence of obstructive malformations and endometriosis [14]. This retrospective study investigates whether patients with uterine malformations have a higher prevalence of endometriosis. The study includes patients with uterine malformations who were admitted to our hospital in the period from 01.12.2014 to 30.11.2019. 279 cases were analysed. 263 (94.2%) patients had a non-obstructive uterine malformation, 12 (4.3%) patients had an obstructive uterine malformation and 4 (1.4%) patients had uterine agenesia/hypoplasia. 209 (74.9%) patients had histologically confirmed endometriosis (peritoneal, ovarian or deep infiltrating) and 70 (25.1%) had no endometriosis. In 27 cases, deep infiltrating endometriosis (ENZIAN ABC) was detected additionally to peritoneal and ovarian endometriosis. The study shows a high prevalence of endometriosis in women with uterine malformations. For this reason, endometriosis should always be specifically sought in uterine malformations.

AYURVED APPROACH TO ENDOMETRIOSIS – A CASE STUDY

Endometriosis is the most upcoming disease that affects the quality of life of millions of women and their families worldwide. It is one of the obscure and captivating benign gynaecological disorders defined by implantation of functioning endometrial tissue outside the uterine cavity. Endometriosis is associated with a broad range of symptoms including Dysmenorrhoea, Dyspareunia, Chronic intermenstrual pelvic pain, and Infertility. The prevalence of Endometriosis in women of Reproductive age is 6-10%. It can be compared as a syndrome complex of Paripluta Yonivyapada in Ayurveda. Thus, Vata evum Pitta shaman treatment along with regimen is given in it. Aim and Objectives: To evaluate the efficacy of Shodhana Chikitsa as Yog Basti, Uttarbasti and Shamana Aushadhi, in the management of Endometriosis. Materials and Methods: It is the single arm, open labelled case study of the subject of 36 yrs. age with Endometriosis who has been treated with Shodhana Chikitsa as Yog Basti, Uttarbasti and Shamana Chikitsa simultaneously. Observation and Result Chief complaints of Patient i.e. Adhodarashula (Lower abdominal pain) and Kashtartava (Pain during menstruation) were relieved. USG reports confirms and substantiates the clinical symptom free evidence. Conclusion: The selected treatment protocol i.e. Shodhana Chikitsa as Yog Basti, Uttarbasti and Shamana Aushadhi, are found very effective in the management of Endometriosis.

Comparison of the symptoms and localisation of endometriosis involvement according to fertility status of endometriosis patients

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 statementWhat 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.

Clinical presentation of endometriosis identified at interval laparoscopic tubal sterilization: Prospective series of 465 cases

ObjectivesWomen seeking sterilization are usually parous and have no major complains, such as pelvic pain. This could be a good model to indirectly assess the prevalence of endometriosis in the general population. Prevalence of endometriosis in women undergoing tubal sterilization by laparoscopy has been assessed in 17 published reports. Results indicate a surprising wide variation of prevalence of endometriosis, ranging from 1.4% to 43.3%. This clinical study describes the prevalence and clinical presentations of endometriosis identified at interval laparoscopic tubal sterilization, as a close representation of endometriosis in general population. Material and methodsFrom July 1989 to February 2009, 465 women undergone interval laparoscopic tubal sterilization and were included in this series. Surgery was realised in a non universitary centre of gynecologic surgery. All patients were operated on by the same surgeon. A complete assessement of pelvic organs was achieved with a particular attention paid for endometriotic lesions. Endometriosis when present was staged according to r-AFS classification. Biopsies were sent for pathological examination to assess endometriosis. ResultsMean age of women was 40.7 years (range 15–49 years). 20 women were nulliparous and 12 others had a past history of endometriosis. Endometriosis was visually identified in 55 patients (11.82%), and confirmed by histologic examination in most of cases (50/55: 90.9%). The mean age of women presenting endometriosis at the onset of tubal ligation was 41.27 years. Cases with endometriosis were classified according to the r-AFS. 39,7,8 and 1 cases corresponded to stages I, II, III and IV respectively. In the 20 nulliparous women, the prevalence of endometriosis was 20% (4/20). At the time of laparoscopic sterilization, 91 women presented a painfull condition (dysmenorrhea mainly or dyspareunia). Endometriosis was identified in 16 of them (17.58%). In the group of 360 asymptomatic parous women, the prevalence of endometriosis was 10% (36/360). Nulliparity, associated pelvic pain and retroverted uterus were associated with increased prevalence of endometriosis, without being significant. ConclusionIn our study, the prevalence of endometriosis identified at interval laparoscopic tubal sterilization was 11.82%. In parous asymptomatic women, the prevalence of endometriosis was 10%. The prevalence of endometriosis was slightly increased in nulliparous women, when pain was associated and in women with a retroverted uterus.

Клинико-сонологические особенности эндометриоидных образований яичников у женщин в репродуктивный период

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.

Prevalence of endometriosis at a university hospital in Jeddah, Saudi Arabia

Purpose: To determine the prevalence of endometriosis in women who had gynecologic laparoscopy at a university hospital in Saudi Arabia. Materials and Methods: The hospital records were reviewed to identify all women who had undergone gynecological laparoscopy between January 2008 and December 2013. Results: A total of 190 gynecologic laparoscopies were performed. The indications for laparoscopy were infertility (n = 76; 40%), chronic pelvic pain (n = 34; 17.9%), infertility and chronic pelvic pain (n = 7; 3.7%), ectopic pregnancy (n = 30; 15.8%), pelvic mass (n = 12; 6.3%), removal of a missing intrauterine contraceptive device (n = 6; 3.2%); other indications were documented in 25 cases (13.1%). Endometriosis was diagnosed in 21 women (11.1%). The presenting complaints in women with endometriosis were pelvic pain (n = 7; 33.3%), infertility (n =5; 23.8%), pelvic pain and infertility (n = 6; 28.6%), and pelvic mass (n = 2; 9.5%); the complaint was unknown in one patient (4.8%). Conclusion: Endometriosis was uncommon in women who had undergone gynecologic laparoscopy.

Premenstrual spotting of ≥2 days is strongly associated with histologically confirmed endometriosis in women with infertility

The purpose of this study was to assess the prevalence of endometriosis in women with premenstrual spotting and to determine the predictive value of this symptom in the diagnosis of endometriosis. We conducted a retrospective cohort study of 80 consecutive women who presented to the infertility clinic for evaluation and who subsequently underwent laparoscopic assessment for infertility with or without pelvic pain. Our main outcome measure was the presence or absence of histologically confirmed endometriosis in women with and without premenstrual spotting. Endometriosis was significantly more prevalent in subfertile women who reported premenstrual spotting for ≥2 days relative to women without this symptom (89% [34/38 women] vs 26% [11/42 women]; P < .0001). Multinomial logistic regression analysis demonstrated the presence of premenstrual spotting for ≥2 days to be associated significantly with the presence of endometriosis (odds ratio, 16; 95% confidence interval, 3.9-65.4; P < .01) and red vesicular lesion type (odds ratio, 52.6; 95% confidence interval, 8.6-323.1; P < .001). In this cohort of women with infertility, premenstrual spotting of ≥2 days was associated strongly with histologically confirmed endometriosis and a better predictor than dysmenorrhea or dyspareunia of finding endometriosis at laparoscopy. Premenstrual spotting of at least 2 days was also associated strongly with both higher stage disease and the red vesicular peritoneal endometriosis phenotype.

The relation between endometriosis and ovarian cancer – a review

Endometriosis is known to harbor characteristics substantiating its possible role as a precursor of ovarian cancer. To assess the quality of the literature regarding the association between endometriosis and ovarian cancer and to estimate the extent of this relation. An electronic literature search was conducted in PubMed and 1112 articles dealing with the relation between endometriosis and ovarian cancer were identified. Original articles based on case-control studies, cohort studies and cross-sectional studies were included. Studies consisting of populations with self-reported endometriosis were excluded, as were articles with fewer than 20 cases of ovarian cancer. Twenty-eight studies underwent detailed quality assessments based on the checklists developed by the Scottish Intercollegiate Guidelines Network (SIGN). Meta-analyses were conducted on selected subgroups of ovarian cancer with coexisting endometriosis. None of the 28 studies was given the highest possible rating using the SIGN checklists. The risk of ovarian cancer in women with endometriosis was reported to be a standardized incidence ratio of 1.43-8.95, a rate ratio of 1.6-2.88, an odds ratio of 1.34, with a prevalence of ovarian cancer in 2.0-17.0% of women with endometriosis. Conversely, the prevalence of endometriosis in women with ovarian cancer ranged from 3.4 to 52.6%. Meta-analysis results were weakened by heterogeneity. There is sufficient evidence to conclude that there is an increased risk of developing clear-cell and endometrioid epithelial ovarian cancer for women with histologically verified endometriosis. Nonetheless, prospective cohort studies assessing the relation between endometriosis and ovarian cancer will increase knowledge in this field.

Endometriosis in women with polycystic ovary syndrome (PCOS) and its role in poor reproductive outcomes

Polycystic ovary syndrome (PCOS) has long been known to be associated with poor reproductive outcomes, beyond simply ovulatory dysfunction. The purpose of this investigation was to determine the prevalence of endometriosis in women with PCOS and infertility and to determine the impact of surgical diagnosis and treatment on pregnancy rates in monitored cycles.

Postpartum caecal perforation due to endometriosis

The prevalence of endometriosis in women in the general population is in the region of 10% and it most commonly occurs in the pouch of Douglas, pelvic peritoneum and ovaries. However, extra-genital sites such as the small and large intestine can be involved. Extra-uterine endometrial tissue behaves just as uterine endometrial tissue and, therefore, undergoes hormone-induced changes during the menstrual cycle including bleeding. The clinical consequence of this is severe pain, which is the commonest presentation of endometriosis.1 During pregnancy the endometrial stroma undergoes decidualisation due to hormonal changes and the normally small cells of the endometrial stroma undergo enlargement. Ectopic endometrial tissue also undergoes decidualisation.2,3

Prospective Study of the Prevalence of Endometriosis on Laparoscopy

Study Objective: To determine the prevalence of endometriosis in women undergoing laparoscopic surgery for other indications. Background: Based on studies conducted in the 1980's and 1990's, the prevalence of endometriosis in the general population has been estimated at approximately 4-7% (Sangi-Haghpeykar, H. and Pointdexter A. Epidemiology of endometriosis among parous women. Obstet Gynecol 1995 Jun; 85(6): 983-92). These data were collected before surgeons knew there were typical and atypical appearing endometriosis lesions.

Prevalence of endometriosis in women with systemic lupus erythematosus and Sjögren's syndrome

Endometriosis is associated with a number of immunologic alterations. It has been suggested that autoimmune disorders could be more frequent in patients with endometriosis. The aim of this study is to ascertain whether the prevalence of two well-known autoimmune diseases [systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS)] is increased in women with endometriosis. The clinical charts of four different populations assisted at the same hospital were manually revised: (i) SLE population (n = 120), (ii) SS (n = 22), (iii) endometriosis (n = 342) and (iv) control population (n = 501 consecutive unselected asymptomatic women). Among SLE women, the prevalence of endometriosis was 1.67% (2/120), similar to the 4.39% prevalence of the control group (22/501), the OR being 0.37 [95%CI 0.09-1.59]. Among SS women, the prevalence of endometriosis was 9.09 (2/22), also similar to the control group OR 2.17 [95%CI 0.48-9.90]. In the same way, when comparing endometriosis cases with asymptomatic women, similar frequencies of SLE (0.58% and 0.2%) and SS were found (0% and 0%). Women with endometriosis do not have an increased prevalence of SLE or SS.

Laparoscopic Management of Patients with Endometriosis and Chronic Pelvic Pain

Endometriosis has been traditionally included among the most important causes of chronic pelvic pain (CPP) in women of reproductive age. The main clinical manifestations of endometriosis are dysmenorrhea, dyspareunia, and chronic nonmenstrual pain. Despite the high prevalence of endometriosis in women suffering from CPP, controversy still exists regarding the true association between the stage and extent of this peculiar disease and the severity of pain. Over the last decade, advances in endoscopic technology have enabled gynecologic surgeons to recognize many atypical appearances of the endometriotic implants not known to exist before, thus allowing their complete excision or destruction. Laparoscopic surgery may offer considerable relief in patients with endometriosis and CPP. Although cases with advanced endometriosis seem to benefit the most, we also support surgical treatment in patients with early endometriosis diagnosed using laparoscopy, as many will experience improvement in their symptoms.

The prevalence of spontaneous endometriosis in the baboon (Papio anubis, Papio cynocephalus) increases with the duration of captivity

It is not known whether stress affects the prevalence of endometriosis in women. Baboons with spontaneous endometriosis may be interesting models to study the human disease. For baboons, living in captivity is a period of chronic stress without continuous exposure to pregnancy. This study was done to compare the prevalence of endometriosis between baboons recently captured in the wild and those living in captivity for several years. A diagnostic laparoscopy was performed for screening endometriosis and obtaining biopsies in 104 female baboons including animals that had been captured in the wild less than 1 year ago (n=52, Group I), primates that had been living in captivity for one to two years (n=30, Group II) and animals that had been captured for more than two years (n=22, Group III). The prevalence of clinical and biopsy-proven endometriosis in all baboons was 17% and 12%, respectively. Clinical endometriosis was found more frequently in group III (32%) than in group II (17%) or group I (11%). The prevalence of biopsy-proven endometriosis was also significantly higher in group III (27%) than in groups I and II combined (8%, p=0.03). The results indicate that the prevalence of endometriosis increases with the time spent in captivity. This trend may be explained by more menstrual cycles uninterrupted by pregnancy in captive than in wild baboons, and possibly also by age-related factors or by captivity-associated stress.

The prevalence of endometriosis in women with infertile partners

Laparoscopy was performed on a consecutive series of 174 women complaining of infertility. Forty of these women were the partners of oligospermic or azoospermic men. There was no difference in the prevalence of endometriosis between those women whose partners were fertile and those whose partners were infertile. Women with azoospermic partners had a prevalence of endometriosis of 20.7%, and this is likely to reflect the true prevalence of endometriosis in a group of randomly selected normal women.