Endometriosis Treatment in Delhi
Diagnosis and surgical or medical management of endometriosis and the pain and infertility it causes.
What endometriosis treatment involves
Endometriosis is tissue similar to the uterine lining growing outside the uterus. It causes progressively worse period pain, pain during intercourse, bowel symptoms around periods, and infertility. On average it takes Indian women seven years to be diagnosed, largely because severe period pain is dismissed as normal.
Dr. Tiwari manages moderate to severe endometriosis surgically by laparoscopy, with careful attention to preserving ovarian tissue in women who still want to conceive — an area where over-aggressive surgery does real harm.
Who this is for
- Period pain severe enough to interrupt work or school
- Deep pain during or after intercourse
- Painful bowel movements or bloating around periods
- Infertility with an endometrioma seen on ultrasound
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Assessment
History, examination and a specialist transvaginal scan; MRI where deep infiltrating disease is suspected.
Medical management
Hormonal suppression for pain where fertility is not the immediate goal.
Laparoscopic surgery
Excision of deposits and careful cystectomy that preserves healthy ovarian tissue.
Fertility planning
Ovarian reserve checked before and after surgery, with IVF timed appropriately.
Your results, in writing
Whatever the outcome of endometriosis treatment, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: Seven years of being told period pain is normal
27, R.K. Puram · severe dysmenorrhoea since 16 · infertility 2 years
What she came in with
Pain severe enough to miss two or three days of work every month, pain with intercourse, and pain on opening her bowels during periods. She had been told since she was sixteen that bad periods run in families.
What the workup showed
Transvaginal ultrasound showed a 4 cm left endometrioma and reduced ovarian mobility suggesting adhesions. MRI identified a deep infiltrating nodule at the rectovaginal septum. AMH was 2.1 ng/ml.
What we did
AMH was measured before surgery deliberately. Laparoscopic excision — not ablation or drainage — of stage IV disease, with the endometrioma cystectomy performed with minimal cautery near the ovarian hilum to protect reserve.
Outcome
Pain scores fell from 9 to 2. AMH at six months was 1.7 ng/ml, a modest and expected fall. She conceived naturally eight months after surgery.
The point of this case
Excision recurs far less than ablation, and measuring reserve before operating on an endometrioma is what keeps the surgery from costing her the fertility it was meant to protect.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Ovarian reserve measured before any endometrioma surgery
Excision rather than simple drainage, which recurs
Fertility preservation discussed before surgery in young women
Long-term pain management, not just an operation
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about endometriosis treatment
Will surgery help me conceive?
In mild to moderate disease, laparoscopic excision improves natural conception rates. With large endometriomas the decision is finer, because surgery itself reduces ovarian reserve — sometimes proceeding straight to IVF is better.
Does endometriosis come back?
It can. Recurrence rates are meaningfully lower after proper excision than after ablation or drainage.
Is severe period pain normal?
No. Pain that stops you functioning is a reason to be investigated, not to take another tablet.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.