Endometriosis

Adelaide Endometriosis Research Group

Led by Prof Louise Hull, the Adelaide Endometriosis Research Group is committed to improving awareness of endometriosis, providing evidence-based information and facilitating accessible diagnosis of endometriosis, to women, their families and health providers.

Established in 2006 the group is currently supported by Commonwealth Government Funding, through the Medical Research Future Fund Primary Health Care Research Data Infrastructure Program and the Public Health and Chronic Disease Program, as well as through Endometriosis Australia.

Endometriosis team

L-R: Nicola Mathews, Dr Nimantha Abeygunasekara, Prof Gustavo Carneiro, Dr Hu Wang, A/Prof Louise Hull, Dr Jodie Avery, Dr Beck O鈥橦ara, Aisha Sirop, Kate Chadwick, Yuan Zhang

  • What is endometriosis?

    Endometriosis is a common, chronic, inflammatory disease, causing period pain for 听women and those assigned female at birth. It is where tissue similar to the endometrium grows outside the uterus. Endometriosis is usually underdiagnosed with an average of 听from first symptoms to diagnosis.

    Reproductive hormonal changes each month drive an excruciating cycle of endometriosis breakdown and remodelling. If undiagnosed, chronic pelvic pain, sexual pain, fatigue, anxiety, and depression may result. Endometriosis is associated with an increased risk听of infertility, autoimmune conditions, cancer, and heart disease.

  • Research Team

    听Robinson Research Institute, Group Lead and Chief Investigator

    Louise has worked in fertility services since she graduated as a doctor in 1991. During this time she has been delighted to help many couples conceive, as well as promote the development of improved fertility treatments through research and education. She works at the Robinson Research Institute, 成人大片, Women鈥檚 and Children鈥檚 Hospital, Adelaide and in private practice at .

    Louise became an Obstetrician and Gynaecologist (FRANZCOG) after gaining clinical experience working in IVF units in Christchurch, New Zealand, Cambridge, UK and Adelaide, Australia, including Bourn Hall, the fertility centre where the first IVF baby was born. She was awarded the Certificate in Reproductive Endocrinology and Infertility (CREI) sub speciality qualification by RANZCOG in 2006.

    Louise completed a PhD s in Endometriosis at the University of Cambridge, UK in 2006. She was appointed to the 成人大片 in 2006 where she established and led the Endometriosis Group at the Robinson Research Institute. Her research focuses on the basic science of endometriosis, developing new diagnostics for endometriosis and conducting Phase 3 and 4 pharmaceutical trials.

    She is an international ambassador for the World Endometriosis Society, a Medical Advisory Board member for Endometriosis Australia and EndoNZ and participated in the National Action Plan round Table for Endometriosis by invitation from the Minister of Health. She has several national and international collaborations and has been awarded considerable grant money over the last 2 years to further endometriosis research in Australasia.

    More recently, Louise has conducted research exploring the immunology and biology of implantation and has participated in biotechnology and pharmacology sponsored clinical trials in the IVF industry. She is the Deputy Clinical Leader of the Fertility and Conception Theme at the Robinson Research Institute, the co-chair of the Special Interest Group for Implantation of ASPIRE and has funding for several research projects exploring recurrent implantation failure and miscarriage.听

    Louise publishes widely, presents at international conferences, supervises PhD students and teaches reproductive medicine to medical students, registrars and reproductive medicine fellows. Additionally, Louise has been an associate editor for Human Reproduction, chaired several grant committees, sits on the Jean Hailes Governance Committee for the endometriosis national action plan and has been on the board of 3 IVF and software companies and 2 pharmaceutical medical advisory boards.

    Lastly, Louise has founded 2 IVF units and in her roles as Scientific Director and New Developments Director, has been integral in introducing novel treatments, laboratory methods and models of care to the IVF industry. She is currently the Written Exam Chair for the Certificate in Reproductive Endocrinology and Infertility (CREI) subspeciality for RANZCOG and the treasurer of the ANZCREI society.

    , Robinson Research Institute, Senior Research Fellow and Imagendo Program Lead

    Dr Jodie Avery BA, BAppSc, MPH, PhD is a social researcher with advanced skills in quantitative and qualitative research methodologies, with a background in radiology. Currently Senior Research Fellow with the Robinson Research Institute, 成人大片, and Program Manager of the $1.9M MRFF Funded IMAGENDO Endometriosis Imaging Study, developing a cost-effective, accessible, and accurate method to non-invasively diagnose endometriosis. Artificial intelligence using ultrasound and MRI images will develop diagnostic algorithms that estimate the likelihood that an individual has endometriosis. Images uploaded by in-built software in imaging machines, will be analysed by this algorithm in real time on a cloud-based digital platform.

    As a chronic disease epidemiologist, Jodie鈥檚 research concerns the intersection of chronic reproductive health conditions with psychosocial factors that may influence other awareness, diagnosis and lead to other associated comorbidities. This includes investigating psychosocial and mental health aspects of chronic conditions such as Endometriosis, Polycystic Ovary Syndrome (PCOS), and Incontinence throughout the life course. Jodie hopes to increase awareness and develop new diagnostic techniques for timelier diagnosis, as well as appropriate care suitable for individual needs.

    Jodie was awarded a 2021 Emerging Leader Development Award and a 2019 Women鈥檚 Research Excellence Award from the 成人大片, a 2018 Robinson Research Institute Career Development Fellowship, and a 2018 Australian Federation of University Women SA Trust Postdoctoral Award. In 2017 she undertook a Career Development Fellowship from the NHMRC Centre for Research Excellence in PCOS. An experienced lecturer and tutor, she has taught widely and supervised students across Health Sciences, Psychology and Medicine programs over the past 15 years.

    , Robinson Research Institute, Grant Funded Researcher, EndoZone Project Coordinator

    Dr Beck O鈥橦ara, BBUS(hons), P.G Cert (Health Promotion), PhD is a psychosocial and digital health researcher with experience in both qualitative and quantitative research methods. Dr O鈥橦ara鈥檚 current research focuses on integrating digital health technologies to support endometriosis diagnosis and management. She coordinates the EndoZone project a co-created digital health platform with the endometriosis community, that empowers and supports people affected by the disease. It addresses community driven priorities such as improving doctor and patient communication, addressing pain normalisation and pain management. She is also a CI on the Imagendo project which uses machine learning (AI) to develop an algorithm to diagnose endometriosis from MRI and Transvaginal Ultrasound Images.

    Dr O鈥橦ara completed her PhD at Monash University in 2019, where she conducted a mixed-methods study examining women鈥檚 experiences of managing endometriosis in Australia and the role of self-management in this disease. Prior to this, she established a 10-year research career in chronic disease, health policy and health promotion, working for state and local government, non-profit organisations and universities. She has conducted research in regional and remote areas and has contributed to projects investigating experiences of complex conditions like diabetes and with vulnerable population groups including women from Aboriginal and Torres Strait Islander and culturally and linguistically diverse communities.

    The EndoZone team were awarded the Robinson Research Institute Community Engagement Award. Beck was awarded a Graduate Women Victoria Special Award (2018 & 2019 and a Australian Research Training Program Scholarship (2016-2019).

    , Australian Institute of Machine Learning, Post doctoral Researcher

    Hu Wang is currently a research fellow at Australian Institute for Machine Learning (AIML), the 成人大片, under the supervision of Prof. Gustavo Carneiro. He received a PhD degree in Computer Science from the 成人大片 in 2021. His research is across multiple domains: Medical Image Processing, Multimodal Learning and Machine Learning Theory. He has published multiple papers on top-tier conferences, including ECCV, IJCAI, ACM multimedia and MICCAI . Recently, he is conducting a medical image processing project --- Imagendo. The aim is to detect endometriosis disease with Machine Learning techniques and thus can help promote the intelligent diagnosis of endo medical imaging in Australia. His personal website is .

    , Australian Institute of Machine Learning, Chief Investigator

    Prof Gustavo Carneiro, PhD is a computer scientist with extensive experience in medical image analysis, computer vision and machine learning. He is the recipient of two ARC discovery projects (as lead CI) in the areas above and he is also a CI of the Centre of Excellence in Robotic Vision, where he is the leader of the machine learning group. Prof. Carneiro is the recipient of prestigious international fellowships, such as the Marie Curie International Incoming Fellowship and听the Humboldt Fellowship. He also has valuable industry experience at the Siemens Corporate Research Laboratory (Princeton, USA), where he developed several systems and was granted 6 patents. He has more than 150 publications in peer reviewed journals and conferences, cited more than 6500 times, with h-index 39.

    Ms Yuan Zhang, Australian Institute of Machine Learning

    Ms Yuan Zhang is a Ph.D. student at the 成人大片. Her main research interest is to apply deep learning and computer vision technologies to the field of medical science. Yuan received her master's degree in Data Science from the 成人大片 in 2021, where her research focused on developing an AI-assisted colonoscopy diagnosis system. Before shifting her career towards AI, Yuan obtained a master's degree in Chemical Engineering in 2017 and a bachelor's degree in Bioengineering in 2014.

    Ms Alison Deslandes

    Alison is a specialist obstetric and gynaecological sonographer and researcher. Her clinical ultrasound experience covers public hospitals, private hospitals, private radiology practice and specialist suites. Whilst she has had exposure to all areas of sonography, obstetrics and gynaecology is her passion and primary area of both clinical practice and research. She has a particular interest in imaging of endometriosis and complex gynaecological pathologies.

    She has completed a Masters by Research focusing on the accuracy of transvaginal ultrasound in the diagnosis of endometriosis when performed by sonographers.

    She is heavily involved in the field of medical ultrasound and is the current president of the Australasian Society for Ultrasound in Medicine.

    Dr Nimantha Abeygunasekara

    Dr Nimantha Abeygunasekara is currently, undertaking an internship at the Central Adelaide Local Health Network (CALHN) in 2022.听Nim is a dedicated, hard-working and motivated individual with a passion for learning and self-development.听She has a keen interest in women鈥檚 health, as well as research in the field of Obstetrics and Gynecology, assisting in an update of a Cochrane review 鈥淚maging modalities for the non-invasive diagnosis of endometriosis鈥.听Nim is currently undertaking a Masters of Philosophy looking at General Practitioners Perspectives on the Diagnostic Delay of Endometriosis

    Dr Diksha Sirohi

    Dr Diksha Sirohi is a PhD student at the 成人大片. Her PhD project contributed to the co-creation and evaluation of EndoZone 鈥 an evidence-based digital health platform for endometriosis. Dr Sirohi completed her medical training in complementary medicine and holds a Bachelor of Homoeopathic Medicine and Surgery from Goa University, India. She has clinical experience of 8 years with a special interest in the holistic management of women's health conditions such as PCOS, endometriosis, uterine fibroids and other gynaecological disorders. She holds a Master of Public Health from the University of Queensland. Her research interest lies in the holistic management of endometriosis and improving the healthcare delivery for endometriosis.

    For General Enquires please contact听endostudy@adelaide.edu.au.

  • The Imagendo Endometriosis Research Study

    Endometriosis is a common condition. By the age of 44, one in nine Australian women are diagnosed with endometriosis, a disease that caused 听 in 2016/17. Diagnosis of endometriosis is often delayed, with an average of between onset of symptoms and diagnosis.

    Until recently, the only reliable way of diagnosing endometriosis was to perform keyhole surgery and visualise the endometrial deposits inside the abdomen, ideally verified by microscopic examination of the tissue. This method was considered the 听for the diagnosis of endometriosis but surgery can be problematic, can be difficult to access, and is associated with delays. Now 听recommend imaging for diagnosing endometriosis, providing negative findings do not exclude disease.

    IMAGENDO, led by the 成人大片 aims to remove this surgical diagnostic barrier by developing a novel, accessible, cost-effective, non-invasive diagnostic tool for endometriosis.

    An Artificial Intelligence (AI) algorithm, combining the diagnostic capacity of specialist endometriosis TVUS (eTVUS) and endometriosis MRI (eMRI) scans, will:

    1. Reduce diagnostic delay
    2. Instigate prevention for infertility and chronic pain
    3. Reduce hospital admissions and laparoscopic surgery
    4. Improve mental health by validating patient鈥檚 pain experience.
    5. Promote development of timely, targeted, effective treatments.

    Please see our study webpage

  • EndoZone: Endometriosis Digital Platform

    is an evidence-based platform co-created with people affected by endometriosis. It is funded by the Australian Government Department of Health and Jean Hailes for Women鈥檚 Health. The Design Thinking Framework guided the co-creation process. It has been developed by people affected by endometriosis, along with Australian Endometriosis Associations, General Practitioners, Allied Health Professionals, Nurse Practitioners, Gynaecologists, Researchers, Health Informaticians and Pain Specialists.

    People affected by endometriosis were asked what they needed most from EndoZone. Better communication with doctors about endometriosis and pelvic pain was the top priority among the 347 community members that responded to the survey. More information about period symptoms and what is normal was the next priority, followed by providing methods to help people manage pain better.

    EndoZone was designed to address these priorities. It features an interactive symptom checker and a health report that users can take to their doctor which captures information about diagnosis, symptoms, and treatments. There are self-management strategies to help people manage their endometriosis and pelvic pain symptoms.

    EndoZone also has pages for clinicians. Health professionals can rapidly access the latest ideas about how endometriosis symptoms develop, the best ways of diagnosing endometriosis and the latest treatments, including when to refer for surgery. A section is devoted to the latest research by Australian research groups, which includes ways the community can get involved in research projects to improve diagnostics and treatments for future generations.

  • Endometriosis Clinical Trials Group

    Dr Tran Nguyen

    Dr Sally Reid

    Dr Rituparna Dutta

  • Conferences, Presentations and Workshops
    • 2022 GP Partners CPD workshops 鈥 Adelaide, Port Lincoln, Lyndoch, Mount Gambier听听听听听听
      Making diagnosis more timely and accessible for people with endometriosis
    • 2022: Royal College of Gynaecologists / British Society for Gynaecological Imaging Meeting听
      IMAGENDO: Combining ultrasound and magnetic resonance imaging using artificial intelligence to reduce diagnostic delay.
    • 2022听European Conference on Computer Vision 2022
      Uncertainty-aware Multi-modal Learning via Cross-modal Random Network Prediction听
    • 2022听ASUM deep dive endo day 滨尘补驳别苍诲辞庐听
      Non-Invasive diagnosis of endometriosis using machine learning听
    • 2022 PELVIC PAIN Conference
      Do we need laparoscopy to diagnose Endometriosis?
    • 2022听RANZCOG 听Using non-invasive imaging to diagnose Endometriosis
    • 2022 SEED Symposium
      It鈥檚 time to diagnose endometriosis before ART鈥
    • 2022 Fertility Nurse Association Workshop
      'Screening for Endometriosis and Improving Outcomes'
    • 2022: Queensland Women鈥檚 Health Forum & Health Translation SA
      An evidence-based platform co-created with people affected by endometriosis.
    • 2021听ISUOG 2021
    • 2021: World Congress on Endometriosis (WCE).听
      • Artificial Intelligence for Sliding Sign Detection to Diagnose Endometriosis
      • Engaging the Australian endometriosis community in the design of a digital health platform
      • The role of self-management among women with endometriosis
      • Challenges of managing endometriosis: the patients鈥 perspective
      • WHISE. Managing endometriosis in Australia, March 2021
      • Endometriosis Support SA, Endometriosis research update, March 2021
      • Adelaide Pelvic Pain Network. Endometriosis Research Update (clinicians), May 2021

  • Publications

    听

    1. Shetty A, Delanerolle G, Zeng Y, Qing Shi J, Ebrahim R, Pang J, Hapangama, D, Sillem, M, Shetty S, Shetty B, Hirsch M, Raymont V, Majumder K, Chongm S, Goodison W, O鈥橦ara R, Hull L, Pluchino N, Shetty N, Elneil S, Fernandez T, Phiri P, Brownstone R (2022) A Systematic Review and Meta-Analysis of Digital Application use in Clinical Research in Pain Medicine, Frontiers in Digital Health (4), doi:
    2. Armour, M., Avery, J., Leonardi, M., Van Niekerk, L., Druitt, M. L., Parker, M. A., Girling, J. E., McKinnon, B., Mikocka-Walus, A., Ng, C. H. M., O鈥橦ara, R., Ciccia, D., Stanley, K., & Evans, S. (2022). Lessons from implementing the Australian National Action Plan for Endometriosis, Reproduction and Fertility, 3(3), C29-C39. Retrieved Aug 2, 2022, from
    3. Evans, S., Villegas, V., Dowding, C., Druitt, M., O'Hara, R. and Mikocka-Walus, A. (2021), Treatment use and satisfaction in Australian women with endometriosis: A mixed-methods study. Intern Med J.听听听听听听听
    4. Delanerolle, G. et al. O鈥橦ara, R. Hull, M.L, Majumder, K, Shi, JQ & Raymont, V (2021) A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project. Women鈥檚 Health.
    5. Maicas G, Leonardi M, Avery J, Pannucio C, Caniero G, Hull ML, Condous G. Deep learning to diagnose pouch of Douglas obliteration with the sliding sign on transvaginal ultrasound: a prospective study. Fertility and Reproduction. 2021 (In press)
    6. O'Hara, R., Rowe, H., & Fisher, J. (2021). Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey. Human Reproduction.
    7. O鈥橦ara, R., Rowe, H., & Fisher, J. (2020). Managing endometriosis: a cross-sectional survey of women in Australia. Journal of Psychosomatic Obstetrics & Gynecology.听
    8. O鈥橦ara, R. Rowe, H., Roufeil, L. & Fisher, J. 2019 鈥楽elf-management in condition-specific health: a systematic review of the evidence among women diagnosed with endometriosis鈥, BMC Women鈥檚 Health.
    9. O鈥橦ara, R. Rowe, H., Roufeil, L. & Fisher, J. 2018 鈥楽hould endometriosis be managed within a chronic disease framework? An analysis of national policy documents鈥, Australian Health Review听 Book chapter
    10. Leonardi M, Avery J, Hull ML. 鈥淣ovel diagnostic strategies for Endometriosis鈥 in 鈥淚mmunology of Endometriosis Pathogenesis and Management鈥 Koga K (ed). Elsevier Press ISBN: 9780128209059

  • Media
    1. The Conversation:听
      Rebecca O鈥橦ara & Louise Hull, November 2022
    2. The 成人大片: Faster methods for diagnosing endometriosis,听December 2021
    3. The 成人大片,听The Discovery Pod:听Fertile Ground, September 2021
    4. Facebook Live:听,听August 2021
    5. Cosmos Magazine:听, July 2021
    6. ABC Sunshine Coast:听, January 2021
    7. The Guardian:听, October 2020
    8. Health Times:听, October 2020

  • Funding

    Current funding for the Imagendo Project

    • 2022: ASUM Australasian Society of Ultrasound in Medicine Research Grant:听鈥淩ectal deep endometriosis identification using Artificial Intelligence.鈥 George Condous, Cansu Usuner, Jodie Avery, Catrina Panuccio, Gustavo Carneiro, Louise Hull ($19,966)
    • 2021: Robinson Research Institute Engaging Opportunities: General Practitioners Perspectives on the Diagnostic Delay of Endometriosis. ($14,439)
    • 2021: Medical Research Future Fund鈥檚 Primary Health Care Research Data Infrastructure Grant 鈥淚MAGENDO Diagnosing endometriosis with imaging and artificial intelligence鈥 ($1,990,998)
    • 2021: Emerging Leader Development Award, Faculty of Health and Medical Science UofA ($40,000) Dr J Avery
    • 2020: Endometriosis Australia Endometriosis Research Grant: 鈥淣on-invasive endometriosis diagnosis using machine learning鈥 ($30,000)
    • 2019: Australian Gynaecological Endoscopy Society ($9750)
    • 2019: Lions Club of Gawler ($1000)

    听

    Current funding for EndoZone

    • 2020 鈥 2022: Australian Government Department of Health 鈥 Public Health and Chronic Disease Program ($1.06m)
    • 2019: Jean Hailes for Women鈥檚 Health ($150K)