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Laparoscopic Diagnosis of Endometriosis

Our Austin fertility doctors specialize in diagnosing and treating endometriosis

Based on your symptoms, diagnosis begins with your Austin fertility doctors performing a series of tests. Endometriosis isn’t an easy condition to diagnose. In fact, it takes some women on average 10 years from the onset of symptoms to arrive at a diagnosis. At Texas Fertility Center, we will help expedite the process so that you will no longer be bothered by symptoms and can optimize your chances for getting pregnant quickly.

Many of the symptoms of endometriosis — debilitating cramps, painful intercourse, bowel and urinary disorders and heavy menstrual flow — mirror symptoms associated with other conditions. Endometriosis can be easily mistaken for pelvic inflammatory disease, irritable bowel syndrome and ovarian cysts.

Endometriosis is also difficult to diagnose because symptoms of this gynecological condition often vary from woman to woman. In fact, some women with mild endometriosis experience excruciating pain, while those with advanced endometriosis sometimes have little to no pain at all.

Our physicians are experts in the diagnosis and treatment of endometriosis, and have written many scientific papers about the disease based on their own clinical research.  They also write the chapter on Endometriosis in the Textbook of Gynecology.

Diagnostic tools for evaluating the signs of endometriosis

To help pinpoint the cause of symptoms, our Austin fertility doctors perform the following tests.

Complete medical history, physical examination, and pelvic exam: At your initial visit, you will be asked a series of medical questions and given a pelvic exam. During the exam, your fertility doctor will feel for masses and/or tenderness on the ovaries, the uterus, and in the area behind the uterus. He or she will also check for ovarian size and whether your pelvic organs move freely or if they fail to move at all. Occasionally, endometriosis implants (small, flat patches of endometrial-like cells) may be visible in the vagina or on the cervix, however, small areas of endometriosis are often difficult to see and feel.

Imaging tests:To get a better picture of your reproductive organs and pelvic area, your physician will typically perform a vaginal ultrasound.  This quick, usually painless test, is very effective at seeing endometriosis cysts in the ovaries, as well as evidence of scar tissue (adhesions) between the different pelvic organs.  In rare cases, your physician may ask you to obtain a CT scan or magnetic resonance imaging (MRI). These more sophisticated tests can occasionally help your physician distinguish between different types of ovarian or uterine masses, to aid in the development of an optimal treatment plan.

Laparoscopy:Even if our fertility doctors suspect endometriosis, a surgical procedure called laparoscopy is the only certain way to confirm the diagnosis. Fortunately, your physician will be able to treat your endometriosis during the same procedure.  While you are under general anesthesia, your reproductive surgeon will make a small incision in your naval and insert a laparoscope — a thin operative telescope — that allows him/her to clearly see each of your pelvic organs. Through one or two additional 5 mm incisions, your physician can insert instruments to elevate and separate your pelvic organs if necessary, to insure thorough treatment of endometriosis, removal of scar tissue, and the excision of uterine fibroids if necessary.

Laparoscopy is currently considered the “gold standard” in diagnosing endometriosis and can provide extensive vital information about the degree of endometriosis, and the presence of adhesions (scar tissue) that can cause your pelvic organs to be stuck to each other, raising the likelihood of pelvic pain and reducing the chance for pregnancy. A clinical staging system developed by the American Society for Reproductive Medicine (ASRM) that assigns a specific number of points to endometriosis lesions and scar tissue is used to determine the severity of the condition: I minimal (1-5 points) ; II mild (6-15 points); III moderate (16-40 points); and IV severe (greater than 40 points).

Armed with this information, our Austin fertility doctors will be able to determine the best treatment option(s) for you. For information on how to treat endometriosis, contact us or visit