Endometriosis

Question 1

infertile women are ____ times more likely to have endometriosis than fertile women

Answer 1

6-8

Question 2

risk factors for endometriosis

Answer 2

low BMI, alcohol use, smoking, Caucasian

Question 3

adhesions from endometrosis cause infertility by

Answer 3

impair oocyte release or inhibit ovum capture

Question 4

increased peritoneal concentrations of

Answer 4

prostaglandins, proteases and cytokines

Question 5

inflammatory cytokines increased in peritoneal fluid

Answer 5

IL-1, IL-7 and TNFalpha

Question 6

angiogenic cytokines increased in peritoneal fluid

Answer 6

IL-8 and VEGF

Question 7

history suggestive of endometriosis

Answer 7

chronic pelvic pain, dyspareunia, dysmenorrhea

Question 8

physical exam findings of endometriosis

Answer 8

fixed retroverted uterus, adenexal mass, uterosacral nodularity, thickening or tenderness

Question 9

unwarranted indication for surgical evaluation of endometriosis

Answer 9

laparoscopy of asymptomatic women with infertility to rule out or confirm disease

Question 10

stage 1 points

Answer 10

1-5

Question 11

stage 2 points

Answer 11

6-15

Question 12

stage 3 points

Answer 12

16-40 (endometrioma >1cm)

Question 13

stage 4 points

Answer 13

> 40 (eg obliterated cul-de-sac)

Question 14

hormone treatment does/does not improve the fecundity of infertile women with stage I/II endometriosis

Answer 14

does not

Question 15

NNT for laparoscopic ablation/resection of endometriosis for live birth

Answer 15

12

Question 16

size of endometrioma for cystectomy

Answer 16

4cm

Question 17

next step after first infertility surgery

Answer 17

ART

Question 18

surgery does/does not benefit asymptomatic women with an endometrioma prior to scheduled IVF/ICSI

Answer 18

does not

Question 19

administration of GnRH agonists for _______ months prior to IVF increases the odds of clinical pregnancy (OR 4.3)

Answer 19

3-6 months

Question 20

women with endometriosis have increased risk of ________ in pregnancy

Answer 20

preterm labor, pre-ecclampsia, bleeding, cesarean section

Question 21

treatment options for women over 35 with endometriosis

Answer 21

SO/IUI or IVF (be more aggressive)

Question 22

treatment for advanced endometriosis

Answer 22

surgery or IVF (no expectant management)

Question 23

surgery for endometrioma >4cm should be considered in order to

Answer 23

confirm diagnosis (r/o cancer), improve access to follicles and possibly improve ovarian response

Question 24

management plan for endometriosis should consider

Answer 24

female age, stage of disease, duration of infertility and pelvic pain