Current Challenges in the Diagnosis of Deep Infiltrating Endometriosis

Deep infiltrating endometriosis (DIE) is a debilitating subset of endometriosis with an ill-defined set of symptoms and lacks specific diagnostic criteria to identify, leading to significant delays in treatment. Endometriosis itself is associated with chronic pain and infertility, leading to significant healthcare costs. A literature has shown that DIE is a non-progressive and curable disease. Currently, diagnosis is based purely on surgical diagnosis, which carriers a higher rate of morbidity, and fear of surgery or reluctance on behalf of provider, may delay diagnosis and thus treatment. Multiple attempts have been made to create an appropriate classification system mainly based on symptoms or imaging, however no one scheme has been successful to appropriately identify DIE. Research has now been geared towards the use of biomarkers, including blood, urine, peritoneal/follicular fluid, or endometrial tissue, to construct a diagnostic tool for DIE. This has the potential to create a less invasive mechanism for earlier identification and treatment of this curable disease.