الفهرس 
Introduction
ETIOLOGY OF INFERTILITYOnly 14 pages are availabe for public view
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Abstract
Endometriosis is a disease of complex aetiopathogenesis. It is often called the disease of theories.Several theories to explain the evolution of endometriosis have been suggested, but no single theory explains all types and sites of endometriosis (Amer, 2008).
The aim of our study were to:
1. Evaluate the incidence of endometriosis in infertile women by laparoscopy in which their ultrasound examination did not detect any ultrasound signs suggestive of endometriosis.
2. Evaluate the incidence of endometriosis in infertile women by laparoscopy in which their ultrasound examination is showing lesions suggestive of endometriosis.
Our study included 100 infertile females, 73 of whom had primary infertility while the other 27 cases had secondary infertility.
Patients with secondary infertility tended to be older in age than those with primary infertility, as about 52% of secondary infertility patients were older than 30 years, compared to only 23% among the primary infertility patients. The difference in age between the two groups was significant with a p value of 0.03.
Most of cases (73% in the primary infertility and 67% in the secondary infertility) has an infertility duration of less than 5 years. There is no significant difference between the two groups as regards duration of infertility.
Laparoscopic findings of endometriosis were seen in 16 patients, 12 of them had primary infertility, and 4 had secondary infertility. So, endometriosis was seen in 16.4% of primary infertility patients and 14.8% of secondary infertility patients, with non significant difference between the two groups.
Most of cases showed regular cycle, with only 21 patients had irregular cycle. Of these 21 cases, 3 had laparoscopic signs of endometriosis. There was no significant relation between cycle regularity and endometriosis.
Most of the cases of endometriosis had congestive dysmenorrhea (9 out of 16), which is opposite to the case in those with negative signs for endometriosis, where spasmodic dysmenorrhea was the most frequent symptom (56 case out of the 84). The difference was significant.
Dyspareunia was seen in 45 cases out of the total of 100 cases. Of these, endometriosis was seen in 24.4% of cases suffering from dyspareunia, compared to only 9.1% only among patients with no symptoms of dyspareunia. The difference was significant.
Although pelvic pain was seen in nearly one third of the cases with no endometriosis, compared to 50% of patients with endometriosis, the difference was non significant.
Abnormalities in the hormonal profile were seen in 25% of our study cases, with no significant relation to the occurrence of endometriosis.
Among the 16 cases with endometriosis diagnosed by laparoscopy, ultrasonography could diagnose only 5 cases. The remaining 11 cases showed no signs of endometriosis by ultrasonography (false negative results) with no false positive cases detected. This difference was highly significant.
Among the 16 cases with positive laparoscopy for endometriosis, histopathology was done in 9 cases, and histopathology was positive in only 5 out of 9 cases (55.6%).
Previous pelvic operations were done in 28 cases, 5 of which had endometriosis and 23 had not. The difference was non significant.
Regarding the stages of laparoscopic endometriosis, the majority of our cases showed either minimal (6/16) or mild (5/16) stage; with only one case had moderate stage and the remaining 4 cases had severe stage of endometriosis. There was non significant relation between the stage of endometriosis and the presence and type of dysmenorrhea.
Regarding the type of lesion, 11 cases out of the 16 had superficial endometriosis (6 were classical and 5 were non classical). Endometrioma was seen in 5 cases, and lastly no cases had deep infiltrating endometriosis.