This book presents an overview of the diagnostic performance of non- or semi-invasive tests for
endometriosis in peripheral blood endometrium saliva peritoneal fluid and urine. The value
of existing and emerging systems biology technologies for biomarker development is addressed in
several chapters on genetics microarrays proteomics and metabolomics. Although tests with
high sensitivity and acceptable specificity have been developed sometimes validated in
independent populations and seem promising more research is needed to translate these data
into clinical benefit for patients and coordinate efforts internationally to standarize
analysis reports and operating procedures. The gold standard to diagnose endometriosis is
currently through laparoscopic inspection with histological confirmation a surgical procedure
with rare but significant potential risks for the patients. A non-invasive test for
endometriosis would be critical for the early detection of endometriosis of symptomatic women
with pelvic pain and or subfertility with normal ultrasound. This would include nearly all
cases of minimal-mild endometriosis some cases of moderate-severe endometriosis without a
clearly visible ovarian endometrioma and cases with pelvic adhesions and or other pelvic
pathology who might benefit from surgery to improve pelvic pain and or subfertility. Such a
test would also be useful in symptomatic women with ultrasound imaging suspicious for
endometriosis since it may be difficult to differentiate an ovarian endometrioma from other
ovarian cysts and since the quality of ultrasound imaging is highly variable worldwide.
