• M van der Zanden, M W J Arens, BraatD D MDDMDepartment of Gynaecology and Obstetrics, (791), Radboud University Medical Center, PO Box 9101, Nijmegen HB 6500, the Netherlands., W L M Nelen, and A W Nap.
• Department of Gynaecology and Obstetrics, (791), Radboud University Medical Center, PO Box 9101, Nijmegen HB 6500, the Netherlands. Electronic address: Moniek.vanderzanden@radboudumc.nl.
• Reprod. Biomed. Online. 2018 Dec 1; 37 (6): 761-768.

Research QuestionTo evaluate implementation of the key recommendations of the European Society of Human Reproduction and Embryology (ESHRE) guidelines on endometriosis, and to assess factors influencing diagnostic delay of endometriosis from Dutch gynaecologists' point of view.DesignQuestionnaire study among gynaecologists from all hospitals in the Netherlands. The questionnaire consisted of 56 questions relating to implementation of the ESHRE guidelines, organization of endometriosis care and diagnostic delay.ResultsGynaecologists from 67 out of 85 hospitals completed the questionnaire. A total of 99-100% of respondents agree with, and 91-100% adhere to, the diagnosis-related recommendations in the guidelines. Diagnostic delay is estimated at 42 months. Main factors contributing to diagnostic delay according to gynaecologists are lack of knowledge and awareness of endometriosis in both patients and medical professionals, as well as limitations in diagnostics and late referral. Suggested interventions to reduce diagnostic delay are aimed at improving knowledge and awareness in both patients and medical professionals, as well as improving collaborations between medical professionals.ConclusionsOverall familiarity with, and use of, the 2014 ESHRE guidelines among Dutch gynaecologists is high. Dutch gynaecologists agree with the recommendations relating to diagnosis and adhere to them closely. Diagnostic delay, however, is still considerable; therefore, efforts to reduce diagnostic delay of endometriosis should be aimed at improving knowledge and awareness in both patients and medical professionals, as well as improving collaboration.Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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