Epidemiological study and clinical consequences of endometriosis and PCOS co-occurrence in a clinical population of women: a cross-sectional study

This study aimed to determine the prevalence of polycystic ovary syndrome (PCOS) co-occurrence in a clinical population of women with endometriosis and to quantitatively assess its impact on infertility, symptom severity, and quality of life. In this cross-sectional study, data from 380 patients diagnosed with endometriosis at Amir al-Momenin Hospital in Zabol (2018-2023) were analyzed. Endometriosis was diagnosed clinically and via imaging (transvaginal ultrasound/MRI), and PCOS was identified using the Rotterdam criteria. Data on infertility, symptom severity (Visual Analog Scale), dyspareunia, and quality of life (EHP-30 questionnaire) were collected. Statistical analyses included descriptive statistics, Chi- Stata square tests, t-tests, and age-adjusted logistic regression. The analysis was conducted using Stata version 17 software. The co-occurrence rate of PCOS among women with endometriosis was 24.5%. Women with both conditions had a significantly higher prevalence of infertility (25.6% vs. 15.4%, p=0.043) and severe symptoms (84.9% vs. 12.2%, p<0.001). After adjusting for age, the comorbidity was associated with significantly increased odds of infertility (adjusted OR=1.88, 95% CI: [1.01-3.50], p=0.048) and profoundly poorer quality of life (adjusted (OR=91.0, 95% CI: [40.0-206.0], p<0.001. The co-occurrence of endometriosis and PCOS is prevalent and is linked to significantly worse clinical outcomes, including nearly double the odds of infertility and a dramatic reduction in quality of life. These findings highlight the necessity for systematic screening for PCOS in women with endometriosis and underscore the need for integrated management strategies for this high-risk population.