Prevalence and Reproductive Impact of Endometriosis Among Subfertile Women: An Observational Study at a Tertiary Care Hospital

Background: Endometriosis is a chronic, estrogen-dependent disorder characterized by endometrial-like tissue outside the uterus, frequently linked to pain and subfertility. It affects nearly 10% of reproductive-aged women and up to 50% of those with infertility. The disease impairs fertility through anatomical distortion, inflammation, ovarian dysfunction, and reduced endometrial receptivity. Early recognition and treatment are vital, as delayed diagnosis worsens reproductive outcomes and reduces the effectiveness of assisted reproductive techniques. Objective: To determine prevalence and reproductive impact of endometriosis among subfertile women, analyzing clinical features, lesion site, stage, and outcomes. Methods: This observational study was conducted in the Department of Obstetrics and Gynecology, Shaheed Monsur Ali Medical College, Dhaka, from January 2023 to December 2023. A total of 132 subfertile women were evaluated using clinical history, ultrasonography, and laparoscopy when indicated. Inclusion and exclusion criteria were applied, and data was collected systematically. Analysis was performed with SPSS version 26. Ethical approval and written informed consent were obtained, ensuring confidentiality and adherence to research ethics. Results: Among 132 subfertile women, the mean age was 30.2 ± 4.8 years, with most aged 25–34 years (66.6%). Housewives formed the majority (65.2%), and 39.4% had been married 5–7 years. Dysmenorrhea affected 75.7%, while infertility alone or with dysmenorrhea was reported in 66.7%. Ovarian lesions were most common (48.5%), and 69.7% had primary subfertility. Moderate to severe disease was found in 65.2%. Post-treatment, 51.5% conceived, while 48.5% remained infertile. Conclusion: Endometriosis significantly impacts subfertile women, with high moderate-to-severe disease; early diagnosis and fertility support improve reproductive outcomes.