Non-invasive diagnosis of endometriosis: the goal or own goal?

Laparoscopy is the gold standard for the diagnosis of endometriosis. Although some forms of the disease, such as ovarian endometriomas or deep infiltrating lesions, can now be reliably diagnosed using non-invasive instruments, adhesions and superficial implants cannot be identified without surgery. Identification of these latter forms of the disease has been the main rationale for claiming the necessity to identify non-invasive diagnostic tests to detect endometriosis. In this opinion paper, we analyse the pros and cons of the availability of this kind of test in the current context of our knowledge of the disease. In particular, we emphasize that this instrument may be of benefit provided that the test is not used as a screening test.