Prevalence of endometrioma and deep infiltrating endometriosis at transvaginal ultrasound examination of subfertile women undergoing assisted reproductive treatment

Alson, Sara; Jokubkiene, L.; Hénic, Emir; Sladkevicius, P.

doi:10.1016/j.fertnstert.2022.07.024

Cited by 20 publications

(18 citation statements)

References 45 publications

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“…In this study, the prevalence of deep and/or ovarian endometriosis in women attending our general gynecology clinic was 18.9%. This is consistent with a recent study that reported an ultrasound-based prevalence of 21.8% in women undergoing their first assisted reproductive treatment, using the same diagnostic criteria as those in this study 14 . However, previous prospective ultrasound-based studies reported a much lower prevalence 12,13 , between 4.9% and 6.4%.…”

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

“…Only four other published studies have tried to determine the prevalence of endometriosis using TVS [11][12][13][14] . One was limited by its retrospective design 11 , the second was conducted with the primary objective of determining the prevalence of adenomyosis 12 , the third included pregnant women only 13 and the fourth women with subfertility only 14 . This study aimed to determine the prevalence of deep and/or ovarian endometriosis in a large consecutive cohort of premenopausal women attending our general gynecology clinic, using ultrasound, and to investigate which demographic characteristics and other pelvic abnormalities were associated with endometriosis.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of deep and ovarian endometriosis in women attending a general gynecology clinic: prospective cohort study

Chaggar

Tellum

Thanatsis

et al. 2023

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?This is the first large prospective study to investigate using a non-invasive approach the prevalence of endometriosis in women with a wide range of complaints attending a gynecological outpatient clinic. What are the clinical implications of this work?We found that deep pelvic endometriosis was much more prevalent than thought previously. It is therefore important that effective non-invasive diagnostic tests are offered routinely to women during their initial outpatient visit to facilitate timely diagnosis and effective treatment of this often-debilitating disease.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of deep and ovarian endometriosis in women attending a general gynecology clinic: prospective cohort study

Chaggar

Tellum

Thanatsis

et al. 2023

Ultrasound in Obstet & Gyne

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“…The low prevalence of 15.9% of patients with endometriosis in our consecutive series of 2288 THL can be explained by the fact that all these patients had a normal clinical examination and normal ultrasound; the incidence in our study is comparable by the hazardous finding of endometriosis in 21.8% in sub-fertile patients referred for IVF treatment with the presence of an ovarian endometrioma in 10.5% of the patients (Alson et al, 2022). If endometriosis pathology was diagnosed by ultrasound or clinical examination these patients are not included in our study as they were referred for a standard operative laparoscopic procedure.…”

Section: Discussionsupporting

confidence: 50%

Diagnosis and treatment of early-stage endometriosis by Transvaginal Hydro laparoscopy

Puttemans¹,

Segaert²,

Valkenburg³

et al. 2023

Facts Views Vis ObGyn

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Background: Transvaginal Hydro Laparoscopy (THL) is known as a minimal invasive procedure allowing endoscopic exploration of the female pelvis. Objective: To evaluate the possibilities of the THL as a tool for early diagnosis and treatment of minimal endometriosis. Materials and methods: A retrospective study of a consecutive series of 2288 patients referred for fertility problems to a tertiary centre for reproductive medicine was undertaken. Mean duration of infertility was 23.6 months (SD ±11-48), mean age of patients was 31.25 (SD± 3.8y). With normal findings at clinical and ultrasound examination patients underwent, as part of their fertility exploration, a THL. Main outcome measures: Evaluation of feasibility, identified pathology and pregnancy rate. Results: Endometriosis was diagnosed in 365 patients (16%); the localisation was higher on the left side (n=237) than on the right side (n=169). Small endometriomas, with diameters between 0.5 and 2 cm, were present in 24.3% (right side in 31, left side 48 and bilateral 10). These early lesions were characterised by the presence of active endometrial like cells and a pronounced neo-angiogenesis. Destruction of the endometriotic lesions with bipolar energy resulted in an in vivo pregnancy rate (spontaneous/IUI) of 43.8% (CPR after 8 months: spontaneous 57.7%; IUI/AID 29.7%). Conclusion: THL allowed in a minimally invasive way an accurate diagnosis of the early stages of peritoneal and ovarian endometriosis with the possibility of offering treatment with minimal damage. What is new? This is the largest series reporting the usefulness of THL for the diagnosis and treatment of peritoneal and ovarian endometriosis in patients without obviously visible preoperative pelvic pathology.

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“…17 The adnexa and pelvis were assessed for endometriomas, defined as unilocular cysts with ground glass echogenicity 21 or as deep endometriotic lesions, which were reported using the International Deep Endometriosis Assessment group terminology. 18,22…”

Section: Study Population and Designmentioning

confidence: 99%

Prevalence of adenomyosis features in women scheduled for assisted reproductive treatment, using the Morphological Uterus Sonographic Assessment group definitions

Alson,

Jokubkiene,

Henic

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionStudies that use standardized ultrasonographic criteria to diagnose adenomyosis in subfertile women are needed. These would improve the understanding of the disease burden and enable further studies on its impact on fertility and assisted reproductive treatment (ART) outcome. The aim of this study was to determine the prevalence of different features of adenomyosis in women scheduled for their first ART, diagnosed at two (2D) and three‐dimensional (3D) transvaginal ultrasonography (TVUS) using the revised Morphological Uterus Sonographic Assessment (MUSA) group definitions.Material and methodsThis was a prospective, observational cross‐sectional study of subfertile women aged 25 to ≤39 years, that were referred to a university hospital for their first ART between December 2018 and May 2021. Of 1224 eligible women, 1160 women fulfilled the inclusion criteria and consented to participate in the study. All women underwent a systematic 2D and 3D TVUS examination. The primary outcome was the presence of direct and indirect features of adenomyosis, as proposed by the MUSA group. Secondary outcomes were to describe the ultrasonographic characteristics of the different features, as well as any difference in the diagnostics at 2D or 3D TVUS and any association with clinical characteristics such as endometriosis.ResultsAt least one direct or indirect feature of adenomyosis was observed in 272 (23.4%, 95% confidence interval [CI] 21.0–25.9) women. Direct features that are pathognomonic for the disease were observed in 111 (9.6%, 95% CI, 7.9–11.3) women. Direct features were visible only at 3D TVUS in 56 (4.8%, 95% CI 3.6–6.1) women, that is, 56/111 (50.5%) of women with at least one direct adenomyosis feature. Direct features were more common in women with endometriosis (OR 2.8, 95% CI 1.8–4.3).ConclusionsWe found than one in 10 women scheduled for ART had direct features of adenomyosis at ultrasound examination. The present study suggests that the use of 3D TVUS is an important complement to 2D in the diagnostics of adenomyosis. Our results may further improve the counseling of women scheduled for ART and enables future studies on the impact of different features of adenomyosis on subfertility, ART results and obstetric outcomes.

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Prevalence of endometrioma and deep infiltrating endometriosis at transvaginal ultrasound examination of subfertile women undergoing assisted reproductive treatment

Cited by 20 publications

References 45 publications

Prevalence of deep and ovarian endometriosis in women attending a general gynecology clinic: prospective cohort study

Prevalence of deep and ovarian endometriosis in women attending a general gynecology clinic: prospective cohort study

Diagnosis and treatment of early-stage endometriosis by Transvaginal Hydro laparoscopy

Prevalence of adenomyosis features in women scheduled for assisted reproductive treatment, using the Morphological Uterus Sonographic Assessment group definitions

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