New Nonsurgical Test for Endometriosis Highly Accurate


Until now, the only way to accurately diagnose endometriosis has been with a surgical procedure called a laparoscopy. Now scientists have developed a quick, nonsurgical approach that is nearly 100 percent accurate. A report of the new test for endometriosis appears on the current online issue of Human Reproduction.

Endometriosis is a chronic disease that affects approximately 5 to 10 million females in the United States and Canada. The disease most often affects women in their thirties and forties, according to the American College of Obstetricians and Gynecologists, but can occur anytime in women who menstruate.

In endometriosis, tissue like that found inside the uterus—the endometrium—grows outside this organ, most commonly on the fallopian tubes, ovaries, exterior of the uterus or intestines, and surface of the pelvic cavity. This tissue acts like the endometrium, which means it responds to menstrual cycle changes. Thus women typically experience pain in the pelvis, lower stomach, and/or back. Painful urination and/or bowel movements during periods, gastrointestinal disorders, painful intercourse, infertility, and fatigue also can occur.


An international team of researchers from Australia and Jordan discovered that by testing a small sample (biopsy) of the endometrium for the presence of nerve fibers, they can diagnose endometriosis with nearly 100 percent accuracy. The sample can be taken easily in an office setting by inserting the collection device through the vagina.

In the current study, the researchers collected endometrial biopsy from 99 women who had pelvic pain, infertility, or both, and who were undergoing laparoscopy for the condition. When the results of the biopsies were compared with those of the laparoscopies, all but one of the 64 women who had endometriosis confirmed by laparoscopy also tested positive for nerve fibers in their biopsy. Among the 35 women for whom laparoscopy did not find endometriosis, 29 did not have nerve fibers. Of the six who had nerve fibers but no diagnosis of endometriosis, three women reported severely painful sex and periods, one had adhesions, and one had a previous history of endometriosis.

In another international study also published in Human Reproduction, a research team found that women who have endometriosis have a nerve fiber density about 14 times greater than that in healthy women. Women who had painful symptoms and endometriosis had significantly greater nerve fiber density than women with infertility but no pain.

Diagnosing endometriosis via laparoscopy involves hospitalization, use of anesthetic, and possible risks associated with the procedure, including having a negative impact on fertility in women who do not have endometriosis. The new nonsurgical technique is faster, much less costly, much more convenient, and more accurate than the surgical approach.

Al-Jefout et al. Human Reproduction 2009; DOI: 10.1092/humrep/dep275
American College of Obstetricians and Gynecologists
Boker A et al. Human Reproduction 2009; DOI: 10.1093/humrep/dep283