Correlation of Clinical Examination and Laparoscopic Staging in Endometriosis among Infertile Women

Background: Endometriosis is a significant cause of infertility in women, often underdiagnosed due to its variable clinical presentation. This study aimed to assess the correlation between clinical examination findings and laparoscopic staging of endometriosis in infertile women. Methods: This was a cross-sectional descriptive study conducted at the Center for Assisted Reproduction (CARE), Department of Obstetrics & Gynaecology, BIRDEM General Hospital, Dhaka, Bangladesh, over two years from July 2013 to June 2015. In this study, we included 127 patients undergoing diagnostic laparoscopy for evaluation of infertility during the study period at our institution. All eligible participants were recruited conveniently based on their scheduled laparoscopic evaluation for infertility. Results: The mean age of participants was 29.31 ± 4.08 years, with the majority experiencing secondary infertility (71.65%). Endometriosis was diagnosed in 18.9% of cases, with Stage I (37.5%) being the most common presentation. Severe dysmenorrhea and chronic pelvic pain were significantly associated with Stage II and Stage IV endometriosis (p < 0.05). Menorrhagia and dyspareunia also showed significant correlations with advanced stages. Pelvic tenderness, restricted uterine mobility, and a fixed retroverted uterus were more frequently observed in moderate to severe stages, with significant associations noted particularly in Stage II. Laparoscopy additionally revealed polycystic ovaries in 37% of cases, adhesions in 25.2%, obliteration of the Pouch of Douglas in 13.4%, and tubal occlusion in 25.9%. No abnormalities were found in 22% of patients. Conclusion: This study showed that clinical symptoms such as dysmenorrhea, chronic pelvic pain, and dyspareunia, as well as specific pelvic examination findings, are significantly associated with laparoscopic stages of endometriosis. Diagnostic laparoscopy remains essential for accurate diagnosis and comprehensive assessment of infertility-related pe