Endometriosis Screening at Markham Fertility Centre in Collaboration with our Radiology Partners Care Imaging
A more complete approach to your fertility care.
Endometriosis Screening
A more complete approach to your fertility care.
What is endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, commonly affecting the ovaries, fallopian tubes, and other pelvic structures. It is a common condition, affecting approximately 1–1.5 million Canadians, yet it is often underdiagnosed. Endometriosis is associated with symptoms such as painful periods, chronic pelvic pain, and pain with intercourse. However, it’s important to note that some patients may have no symptoms at all.
What is endometriosis screening?
Endometriosis screening is a non-invasive test, usually a specialized pelvic ultrasound, that looks for signs of endometriosis, where tissue similar to the uterine lining grows outside the uterus. It uses targeted techniques to assess common areas and detect both superficial and deeper disease. Screening helps identify possible indicators early, especially in those with pain or fertility concerns, but it does not confirm a diagnosis in all cases. Results are interpreted alongside your overall clinical picture.
Why does endometriosis matter for fertility?
Endometriosis is found in approximately 25–50% of infertility patients. In some cases, it may affect fertility by creating inflammation in the pelvis, impacting egg quality or ovarian function, or causing scar tissue and adhesions that alter reproductive anatomy.
However, not all cases of endometriosis affect fertility, and not all findings require treatment. Your care is always individualized.
Our Approach at Markham Fertility Centre
We believe fertility care should be: Thoughtful, evidence-based, comprehensive, and continuously improving.
Endometriosis screening is one way we are delivering more complete care from the very beginning of your journey.
Why are we now screening for endometriosis?
Historically, endometriosis has been difficult to diagnose without surgery (laparoscopy). However, advances in imaging, particularly advanced pelvic ultrasound, now allow many forms of endometriosis to be detected non-invasively. Leading organizations support this modern approach. The Canadian Association of Radiologists (CAR) notes that standard ultrasound is often inadequate for detecting endometriosis, while the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends advanced imaging, often referred to as “mapping,” for improved detection and assessment.
At Markham Fertility Centre, these advances have been fully integrated into clinical practice to help identify contributing factors earlier, provide more complete information from the outset, and enable more personalized treatment planning tailored to each patient’s needs.
What is an endometriosis screening ultrasound?
This is a specialized pelvic ultrasound designed specifically to look for signs of endometriosis. It goes beyond a routine ultrasound by using a targeted scanning technique, carefully assessing areas where endometriosis is commonly found, and evaluating for both superficial and deep disease to provide a more comprehensive and accurate assessment.
How is this different from a regular ultrasound?
A standard pelvic ultrasound (OHIP-covered) is excellent for evaluating ovarian reserve through antral follicle count (AFC), assessing uterine structure, and identifying ovarian cysts. However, it often misses endometriosis, particularly deeper forms of the disease.
Detecting endometriosis effectively requires specialized protocols, advanced equipment, highly trained sonographers, and expert interpretation to ensure a more accurate and comprehensive evaluation.
What happens if something is found?
Your physician will review your results with you and discuss whether they are relevant to your individual situation.
Depending on your specific circumstances, this may include no change to your treatment, further evaluation, a more detailed endometriosis mapping ultrasound, or adjustments to your fertility plan.
All decisions are personalized to ensure the most appropriate care for you.
Does screening mean I have endometriosis?
No. Screening looks for signs of endometriosis but does not confirm a diagnosis in all cases.
Many patients may have normal results or findings that are not clinically significant, meaning that further evaluation or treatment may not be necessary depending on the overall clinical context.
Is there a cost?
No. Endometriosis screening is offered at no additional cost as part of your initial fertility assessment.
To allow this, the screening is scheduled as a separate appointment from your AFC ultrasound for OHIP billing purposes
What is “endometriosis mapping”?
There are two levels of assessment.
The first is a screening ultrasound is the first-line test, offered routinely and at no cost.
The second is an advanced pelvic ultrasound (mapping) is a more detailed and comprehensive evaluation that identifies the location and extent of disease, requires specialized expertise, and is not covered by OHIP, with an approximate cost of $285.
Why is this important?
Endometriosis is often underdiagnosed and is associated with delays in diagnosis of 7–10 years. It is also a significant contributor to pain, infertility, and emotional distress.
Early detection allows for:
- A better understanding of your fertility,
- supports more informed decision-making, and
- enables more tailored treatment strategies.
My Fertility Podcast covers the topic of endometriosis on EP03, EP08 & EP84
Dr. Garcia and Dr. Wais demystify the world of fertility, one topic at a time.
Guest experts Dr. Zeni and
Dr. Leonardi speak about endometriosis, the affects on fertility and treatment options.
Listen on Spotify, Apple Podcasts or wherever you listen to podcasts.
Markham Fertility Centre now offers routine endometriosis screening to:
- All new patients undergoing infertility assessment without a prior history of endometriosis
- Patients having an AFC (Antral Follicle Count) ultrasound
This is part of our commitment to more comprehensive care from the very beginning.
Learn more about endometriosis via The Endometriosis Network Canada.