Pathogenesis and Pathophysiology of Endometriosis

Endometriosis is an inflammatory, estrogen-dependent condition associated with pelvic pain and infertility. This work reviews the disease process from theories regarding origin to the molecular basis for disease sequelae.

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Richard O. Burney, M.D., M.Sc. and Linda C. Giudice, M.D., Ph.D.

Vol 98, Issue 3, Pages 511-519


The exact factor or factors that orchestrate the survival and subsequent implantation of the displaced endometrium remain unknown. Innate or acquired properties of the endometrium and defective immune clearance are systems of interest in elucidating the establishment of endometriotic implants. Disease heterogeneity, particularly in lesional phenotype, requires adherence to histopathologic confirmation of implants in clinical and molecular research. The underpinnings for the observed hallmarks of inflammation, estrogen dependence, and progesterone resistance in the pathophysiology of endometriosis associated pain and infertility are areas of active research. With further advances in our understanding of endometriosis, preventive strategies, novel non-surgical diagnostic modalities and targeted therapeutics hold great promise of becoming realities.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility┬« is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.