Making a diagnosis on thebasis of symptoms alonéis difficult as the presentation is so variable and other conditions such as irritable bowel syndrome and pelvic inflammatory mimic the disease. Consequently, there is often a delay of several years between symptom onset and a definitive diagnosis at laparoscopy. Finding pelvic tenderness, a fixed retroverted uterus, tender uterosacral ligaments or enlarged ovaries on examination is sugges-tiveof endometriosis, although thefindings can benormal. The diagnosis is likely if deeply infiltrating nodules are found on the uterosacral ligaments or in the pouch of Douglas, and is confirmed if visible lesions are seen in the vagina or on the cervix. Such nodules are most reliably detected when the examination is performed during menstruation .
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.