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Findings

In fifty patients with endometriosis and fifty age-matched controls confirmed by laparoscopy or laparotomy, whole blood samples were collected and digested using supra pure 65% HNO3. Whole blood levels of nickel and lead were measured using Total Reflection X-ray Fluorescence (TXRF) while cadmium levels were evaluated using graphite furnace atomic absorption spectroscopy (GFASS). Women with endometriosis had significantly higher (P=0.016) geometric mean (95% CI) whole blood nickel levels [2.6(1.9-3.3) μg/L] as compared to women without endometriosis [0.8 (0.7-0.9) μg/L]. Whole blood levels of cadmium and lead were similar between the two groups.

Methods

This case control study was conducted among women of the reproductive age group, at the Professorial Gynecology Unit of the National Hospital, Colombo, Sri Lanka. Patients awaiting elective laparotomy or laparoscopy for diagnostic and/or treatment purposes were included. Those who were diagnosed visually as having endometriosis subsequent to laparotomy or laparoscopy were selected as cases (n=50). Apart from the ectopic endometrial tissue sample that was collected as described in the previous study [], simultaneous venous blood sample was collected from each case. Women matched for age in whom endometriosis had been excluded by laparoscopy or laparotomy were recruited as controls (n=50). Indications for laparoscopy or laparotomy in controls were subfertility, dysmenorrhea, chronic pelvic pain or detection of an ovarian mass in ultrasound scan.