Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
Open Access

Abstract

Think Endometriosis: Delay in Diagnosis or Delay in Referral to Adequate Treatment?

Adi Y Weintraub, David Soriano, Daniel S Seidman, Moti Goldenberg and Vered H Eisenberg

Objective: To evaluate the decision making of gynecologists in a clinical setting regarding the diagnosis and management of endometriosis. Design: A qualitative questionnaire-based study. Setting: Two local meetings of gynecologists. Participants: Gynecologists in a community and a hospital setting. Intervention: None. Main outcome measure: Physician’s reported management and treatment methods. Results: The questionnaire was answered by 91 gynecologists. Most had at least 10 years of clinical experience (72.2%), 37.8% were community-based, and 5.6% were ultrasound experts. Approximately 62.8% of physicians believe that there is delayed diagnosis of endometriosis. Most would refer the patient to a specialized endometriosis center in the presence of a large pelvic mass, following repeated IVF failure, or due to intractable pain after repeat surgery. Physicians’ seniority or subspecialty did not significantly influence their opinions. Conclusion: It seems that it is not delayed diagnosis that affects the management of endometriosis, but rather delayed referral to targeted investigation and appropriate treatment. Gynecologists in community practice are still largely unaware of the role of specialized care in the management of endometriosis.