Prevalence and Risk Factors of Endometriosis Among Infertile Women in a Tertiary Care Center in South India.

Background Endometriosis is a gynecological conundrum because of its challenging diagnosis and treatment. It seems to affect every aspect of a woman's reproductive system, rendering her incapable of conceiving or achieving a successful pregnancy outcome independently. This study sought to determine the prevalence of endometriosis and clinical attributes of infertile women undergoing diagnostic laparoscopy. Methodology The current research is an analytical cross-sectional study that was carried out from April 2017 to December 2018. We included 103 women diagnosed with infertility and who underwent laparoscopy in the fertility center at Government Medical College Thiruvananthapuram, Kerala, a southern state of India. A semistructured questionnaire was used to collect information on the sociodemographic, menstrual, and reproductive characteristics. Family history and associated symptoms of endometriosis were elicited. Patients were put into four stages by the revised American Fertility Society (rAFS) grading, which was used for the laparoscopic staging. Results Among the 103 cases who underwent laparoscopy, 23 patients (22.3%) were diagnosed with endometriosis. Of the 23 cases of endometriosis, one (4.3%) had minimal endometriosis, two (8.7%) had mild endometriosis, and 10 (43.5%) each had moderate and severe endometriosis. Dysmenorrhea was significantly more prevalent among cases (87%, 20 participants) compared to controls (48.8%, 39 participants) (p = 0.001). Approximately 56.5% (13 participants) of cases had dyspareunia, compared to only 31.3% (25 participants) of controls, and this difference was statistically significant (p = 0.027). About 52.2% of the cases (12 participants) experienced premenstrual spotting, while none of the controls did. The p-value of 0.001 shows a statistically significant difference. Out of the total cases examined, 56.5% (13 participants) reached menarche at or before 12 years, whereas 43.5% (10 participants) attained it after reaching the age of 12. Among the control group, 31.2% (25 participants) of individuals had menarche at or before the age of 12, while 68.8% (55 participants) experienced it later. The difference that was observed had a statistically significant result (p = 0.027). The majority of cases (about 65.2%) experienced cycles lasting less than 21 days, with 30.4% having cycles within the normal range, and 4.3% experiencing cycles longer than 35 days. The significant difference in proportion is evident with a p-value of 0.015. Out of the cases, around 34.8% (eight participants) had a history of pelvic surgery. Compared to the control group, nearly 30.4% of the cases (seven participants) had a positive family history of endometriosis. There were no additional risk factors associated with the development of endometriosis. Conclusion The prevalence of endometriosis among infertile women undergoing diagnostic laparoscopy was more than one-fifth of the study patients. The common complaints were dysmenorrhea, followed by dyspareunia and premenstrual spotting. Risk factors associated with endometriosis were early menarche, frequent cycles, and positive family history.