الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Endometriosis is characterized by the presence of functioning endometrial glands and stroma outside the inner surface of the uterine cavity. The symptoms of endometriosis are not specific, which makes it difficult to depend on, when diagnosing the disease. However dysmenorrhea should direct the attention to the possibility of endometriosis. Other tools that may help in diagnosis include clinical examination, serum markers and imaging investigations. Laparoscopy is considered the gold standard for the diagnosis of endometriosis. Medical treat ment includes symptomatic treatment such as NSAIDs and hormonal treatment which act mainly on estrogen suppression. The hormonal treatment includes progesterone, oral contraceptive pills, aromatase inhibitor, GnRHa and Elagolix. Surgery may be open or laparoscopic. Laparotomy is reserved for patients with advanced stage disease and for whom fertility is not desired. Ablation of endometriotic lesions reduces endometriosis associated pain up to 6 months. The decisions involved in any treatment plan are individual. The management of couples with unexplained infertility should balance the efficacy, cost, safety, and risks of various treatment alternatives. Laparoscopic surgical removal of endometriosis (through either excision or ablation of endometriosis or both) is an effective first-line approach for treating pain related to endometriosis. In women with minimal to mild endometriosis, IUI with controlled ovarian stimulation may be effective in increasing live birth rate, compared with expectant management. Long-term treatment with GnRHa before IVF may improve fertility rates in advanced-stage endometriosis, in this study, endometriosis was diagnosed in 33 % of patients with higher incidence among women aged 25 up to 30 years with no significant association with residence, education or BMI.
OC exposure was associated with a lower risk of endometriosis while prior pelvic surgery was significantly correlated with endometriosis. The disease was more prevalent among first and second degree relatives suggesting familial tendency. According to the recent ASRM classification 13 cases have minimal endometriosis, 6 cases with mild endometriosis, 7 with moderate and 7 with severe endometriosis. Biopsy was taken from laparoscopically diagnosed patients and confirmed the diagnosis of endometriosis in 21 (63.6%) cases. CA 125 was significantly elevated in women with endometriosis.