The Significance of Diagnostic Delay in Endometriosis

remains a clinical challenge with many patients left undiagnosed with an estimated average delay of up to 10.4 years [5,810]. Two thirds of women with endometriosis are initially misdiagnosed and almost half are examined by five physicians or more before a correct diagnosis is made [11]. Diagnostic delay is significantly longer in women presenting with pelvic pain in comparison to those presenting with infertility [5,12,13]. In addition, delay before surgical diagnosis of deep infiltrating endometriosis is significantly longer for patients with advanced stage IV disease than for those with stage I, II or III disease [14]. The endometriosis-associated costs to society are aggravated by delayed diagnosis and empirical treatments, as are the costs to the individual when disease symptoms interfere with daily function [5,15,16].