Saliva test may spare women from unnecessary surgery for endometriosis

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Female aged 18 to 43 2. Strong clinical suspicion of endometriosis based on the following suggestive symptoms: chronic pelvic pain (\> 6 months) that is suggestive and disabling (ENA ≥ 8, absenteeism or resistance to level 1 analgesics) ± deep dyspareunia or painful hematuria/micturition with menstrual rhythm or painful rectal discharge/defecation with menstrual rhythm. 3. Endovaginal ultrasound and MRI (unless contraindicated, in which case only one of the 2 examinations is required\*) less than 1 year old and of sufficient quality , in compliance with the endometriosis protocol recommended by the HAS\*\*. 4. Clinical-radiological discrepancy confirmed by the investigating gynecologist and a referent radiologist at the investigating center, in compliance with the protocol's positivity criteria and the French ENDOVALIRM guidelines (for characterizing deep lesions on MRI) and/or the ESUR 2017 guidelines (for ovarian lesions) and/or the SUR-US 2024 guidelines (for ultrasound). 5. Woman has dated and signed the consent form. 6. Speaks and understands French 7. Affiliated with the French healthcare system Exclusion Criteria: 1. Endometriosis diagnosed according to imaging protocol positivity criteria 2. Differential diagnosis and/or adenomyosis made 3. History of isolated dysmenorrhea well controlled by hormonal contraception and no immediate desire for pregnancy, 4. Absence of pelvic pain strongly suggestive of endometriosis. 5. Isolated fatigue 6. Aetiological work-up incomplete or pending before deciding on initial medical decision (infertility work-up in progress, waiting for specialist opinion (algologist, psychologist, etc.), waiting for important test results), 7. Infertility work-up (current or previous), with no signs suggestive of endometriosis. 8. Search for recurrence of known endometriosis 9. Laparoscopy for gynecological reasons other than suspected endometriosis 10. History of cancer 11. Pregnant or breast-feeding women 12. Current bacterial or viral infection or less than one month old 13. Participation in an interventional study or in the exclusion period of an interventional study