Women who are not exposed to spermatozoa and infertile women have similar rates of stage I endometriosis

Objective: To compare the prevalence of endometriosis and its different sta ges in infertile women and women not exposed to spermatozoa. Design: Prospective study. Setting: Artificial insemination donor program at a university hospital. Patient(s): One hundred fifty women unable to conceive because they had not been exposed to spermatozoa. (134 with azoospermic partner, 10 with an HIV -positive partner, and 6 without a male partner). Controls were 750 women i n infertile couples in which the male partner had normal sperm. Intervention(s): Laparoscopy was systematically performed in a blinded mann er in both groups as part of the infertility work-up. Main Outcome Measure(s): Diagnosis of endometriosis. Result(s): In unexposed women and controls, the prevalence of endometriosis was similar (32% and 34.5%). Rates of stage I disease were also similar in both groups (26% and 19.3%). There was a significant trend toward higher s tages of endometriosis in infertile women (stage IT disease, 3.3% vs. 5.7%; stage III disease, 1.3% vs. 3.1%; stage IV disease, 1.3% vs. 6.4%). Endome triosis was not associated with the few demographic characteristics that di ffered between groups. Conclusion(s): From an epidemiologic point of view, stage I endometriosis i s not more common in infertile women than in unselected women. However, sta ge II to IV endometriosis was more frequent in infertile women. Whereas a r elation between stage I endometriosis and infertility seems unlikely, the r elation between stages II to IV endometriosis and infertility seems possibl e. (C) 2001 by American Society for Reproductive Medicine.