PREVALENCE OF ENDOMETRIOSIS AMONG INFERTILE WOMEN IN TANTA

Abstract

Endometriosis is defmed as the presence of endometrial glands and stroma outside of the uterine cavity. It is one of the most common benign gynaecologic disorders, affecting approximately 5% of the general population. It is most commonly found in the pelvis on the §urface of the ovary, on the pelvic peritoneum, the fallopian tubes and

broad ligament.

Infertility and pelvic pain are of the most common presentations of endometriosis. Often quoted figures regarding this association are that 25-50% of women with infertility have some degree of endometriosis, and pelvic pain occurs in 30-50% of patients with endometriosis. The association between endometriosis and infertility is complex and imperfectly understood. Pelvic pain is arguably the symptom causing the most misery amongst endometriosis sufferers and is more distressing than infertility. In fact the exact prevalence of endometriosis in infertile women is undetected with a variable results depend on many factors. One of these factors; the type of the patients, if they were of special socio - economic class, the childbearing age, the other factor is the study was done in specialized centre for endometriosis and, has the facilities to diagnose the early mild degrees of the disease or the study was done in general hospital . The one of the most important factor that aff ct on the result of study is the technique was used to diagnose the endometriosis if by laparotomy or laparoscopy or laparotomy with biopsy or laparoscopy with biopsy taking or by laparoscopy and aspiration for peritoneal fluid or by using laboratory methods as CA 125 , and other factors . The aetiology of endometriosis is unknown. Many theories explain the occurance of endometriosis but no one of them is sufficient to explain the all evidences of endometriosis. One of these theories is retrograde menstruation theory and coelomic metaplasia theory and many other theories one of the most important one is the immunological theory which showed disturbance in auto - immune system. One of the most important factors for occurrence of endometriosis

is shortening of the menstrual cycle length less than 27 days, the duration of menstrual blood flow more than 8 days, and early age of menarche. Some studies proved that the smoking is protective against occurrence of endometriosis. In the last decades, increasing attention has been drawn to atypical - forms of endometriosis, endometriotic lesions that lack the typical black­ blue, powder-bum appearance. These atypical forms are suggested to occur intermittently in all women, and a continuing growth in .the percentage of patients diagnosed as having subtle endometriosis from 15% to 65% may be related to increased ability for recognition of subtle

lesions.