30th April 2024

A 32-year-old woman presents with a history of chronic pelvic pain, especially during menstruation, and painful intercourse.

A 32-year-old woman presents with a history of chronic pelvic pain, especially during menstruation, and painful intercourse. She reports a long history of irregular and heavy menstrual cycles. She has been trying to conceive for the past year without success. On examination, there is tenderness in the posterior fornix, and a fixed, retroverted uterus is noted.

Which is the most appropriate initial diagnostic investigation in this patient to evaluate for endometriosis?