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Clinical Crossroads Update
August 9, 2000

A 36-Year-Old Woman With Endometriosis, Pelvic Pain, and Infertility, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2000;284(6):749. doi:10.1001/jama.284.6.749

In January 1999 at Obstetrics and Gynecology Grand Rounds, G. David Adamson, MD, discussed a 36-year-old woman who had pelvic pain, severe endometriosis, a complex ovarian cyst, and difficulty conceiving.1 Ms B, the patient, underwent 2 unsuccessful cycles of in vitro fertilization. She and her husband adopted a daughter 1 year prior to the rounds. Dr Adamson explained how endometriosis influences pain and infertility and outlined the differential diagnosis for the condition. He discussed medical and surgical treatment, including hormonal suppression of the ovaries, surgery to remove disease and/or the affected organs, and assisted reproductive technology. He also mentioned the importance of pain management. Dr Adamson pointed out that pregnancy rates in women who undergo surgical treatment for endometriosis are higher than in women who receive medical therapies alone.