Frequency of Endometriosis in Females with Infertility Undergoing Diagnostic Laparoscopy.

is the most common, chronic condition. Although some females are asymptomatic, the majority of women come with infertility, adnexal mass, or pelvic pain. Endometriosis treatment in the context of infertility poses a variety of challenging clinical issues. Objective: The objective of current study is to identify frequency of endometriosis on laparoscopy in females with infertility. Methods: This retrospective study was done at the Department of Obstetrics and Gynaecology, Saint Luke's General Hospital, Kilkenny, Ireland. Medical records of 215 females meeting the inclusion criteria underwent diagnostic laparoscopy were included. Basic demographical details and clinical examination was evaluated and presented through descriptive statistics. On diagnostic laparoscopy, representative sample was taken and sent to hospital histopathology for evaluation of endometriosis. Chi square test was applied to identify the in�uence of variables on endometriosis. Results: Mean age of females was 28.67 ± 6.35 years. Mean duration of marriage was 6.63 ± 5.26 years. There were 80 (37.21%) women in which endometriosis was diagnosed. No signi�cant statistical association was seen for endometriosis with age, infertility type and duration of infertility. Conclusions: The �ndings of this study show an increasing trend in endometriosis identi�cation or occurrence in women with infertility. Endometriosis with infertility is not an uncommon disease in women. Though laparoscopy is intrusive method, but with the right training the issues and complications that come with it can be reduced, which bene�ts the patients and offers us a clear picture or pathology of the disease.

identify and manage, it is an enigma in gynaecology. It causes a wide range of disabling symptoms and has negative consequences on reproductive capacity [5]. Laparoscopy, in addition to providing information on uterine normality, tubal and ovarian status, and other pelvic pathologies, such as pelvic in ammatory disease, endometriosis, tuberculosis, and pelvic congestion. Laparoscopy is the cornerstone in the diagnosis. Because it allows for the visual con rmation of the tiny endometriosis lesions and aids in the staging of the disease [6]. According to a study in Pakistan, endometriosis occurs in 55% of women [2]. Another study from Pakistan found Endometriosis in Females with Infertility

I N T R O D U C T I O N
Endometriosis is the most common, chronic condition. Although some females are asymptomatic, the majority of women come with infertility, adnexal mass, or pelvic pain. Endometriosis treatment in the context of infertility poses a variety of challenging clinical issues. Objective: The objective of current study is to identify frequency of endometriosis on laparoscopy in females with infertility. Methods: This retrospective study was done at the Department of Obstetrics and Gynaecology, Saint Luke's General Hospital, Kilkenny, Ireland. Medical records of 215 females meeting the inclusion criteria underwent diagnostic laparoscopy were included. Basic demographical details and clinical examination was evaluated and presented through descriptive statistics. On diagnostic laparoscopy, representative sample was taken and sent to hospital histopathology for evaluation of endometriosis. Chi square test was applied to identify the in uence of variables on endometriosis. Results: Mean age of females was 28.67 ± 6.35 years. Mean duration of marriage was 6.63 ± 5.26 years. There were 80 (37.21%) women in which endometriosis was diagnosed. No signi cant statistical association was seen for endometriosis with age, infertility type and duration of infertility. Conclusions: The ndings of this study show an increasing trend in endometriosis identi cation or occurrence in women with infertility. Endometriosis with infertility is not an uncommon disease in women. Though laparoscopy is intrusive method, but with the right training the issues and complications that come with it can be reduced, which bene ts the patients and offers us a clear picture or pathology of the disease.
that 16.8% of 796 infertile women had endometriosis [7]. In contrast, a different study found that 6.5% of females experiencing infertility had endometriosis [8]. This current study was done to assess the frequency of endometriosis during laparoscopy among infertile women. Even though a lot of literature available, but the statistics are inconsistent for endometriosis in infertile women i.e. range from 6.5% to 55% [2,8]. Therefore, no inferences about its management and the avoidance of further di culties can be made in light of these shifting gures. The current study's ndings will provide a precise picture of the frequency, allowing us to screen these women early and, with the right care, reduce their burden and associated morbidity.
The current retrospective study was conducted at the Department of Obstetrics and Gynaecology, Saint Luke's General Hospital, Kilkenny, Ireland. Medical records of 215 females who met inclusion criteria and underwent diagnostic laparoscopy from 2013 to 2016 were evaluated. Basic demographic information and a clinical evaluation were assessed. A representative sample was collected during a diagnostic laparoscopy and forwarded to the hospital's histopathology department for endometriosis examination. The collected data were entered and analysed through SPSS version 20.0. Quantitative data like age, duration of infertility was presented in form of mean ± S.D while frequency (%) was used for categorical data like frequency of endometriosis, type of infertility. Data was strati ed for age, types of infertility (primary or secondary) and duration of infertility. Chi square test was applied to identify the in uence of variables on endometriosis, pvalue ≤ 0.05 was considered as signi cant.

R E S U L T S
In the current study, 215 females were included. Results showed the mean age of the females was 28.67 ± 6.35 years. Minimum and maximum age of women was 19 and 40 years respectively. According to gure 1, there were 150 (69.77%) women who had primary and 65 (30.23%) had secondary infertility.   Based on the analysis in  Although a high frequency of primary infertility was seen in women who had endometriosis. But statistically no signi cant association was seen between infertility type and endometriosis. i.e. (p-value=0.803).  [17]. Furthermore, endometriosis is linked to a reduced live birth rate [18]. In the present study, highest frequency of primary infertility i.e. 68.8% was found among females who were diagnosed with endometriosis. Another study shows that up to 50% of women with endometriosis are infertile [19]. Based on typical laparoscopic observations, pelvic anatomical distortion, or the "pelvic factor," can more easily explain i n fe r t i l i t y i n i n d i v i d u a l s s u f fe r i n g f r o m s eve r e endometriosis. Major pelvic adhesions can limit release of oocyte from the ovary, impede ovum pickup, or restrict ovum transport. Endometriosis patients may experience endocrine and ovulatory problems such as luteinized unruptured follicle syndrome, poor folliculogenesis, multiple LH surges and luteal phase defects [20]. Researchers have argued over the relationship between endometriosis and infertility for a long time. Although a signi cant amount of research suggests a link between endometriosis and infertility, a causal relationship has not been proved. Endometriosis, however, can cause pelvic adhesions or abnormal pelvic anatomy that prevent fertility.

C O N C L U S I O N S
The ndings of this study show an increasing trend in endometriosis identi cation or occurrence in women with infertility. Endometriosis with infertility is not an uncommon disease in women. Though laparoscopy is intrusive method, but with the right training the issues and complications that come with it can be reduced, which bene ts the patients and offers us a clear picture or pathology of the disease.