Our findings confirm that angiogenesis occurs following the culture of endometrial tissue in the 3D fibrin matrix, and suggests that Gd and COX-2 might play important roles in promoting neovascularization and cell proliferation in the establishment of endometriosis.

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Endometriosis is the presence of endometrial tissue outside of the uterine cavity and is the most common gynecologic disorder in women of reproductive age. Although the quality of life for women with endometriosis is severely compromised, very little is known about the pathophysiology of endometriosis and current therapeutic strategies provide temporary symptomatic relief but not a cure. Endometriosis remains poorly understood primarily because of an inability to identify patients with early stage disease. Animal models have been developed to study early endometriosis but all have some problems that limit their usefulness in determination of the pathophysiology of endometriosis as it occurs in the human. We have preliminary evidence that in the presence of a three-dimensional fibrin matrix, human endometrial glands, stroma, and neovascularization can develop in vitro, mimicking the earliest stages of endometriosis. We believe this model system reflects the situation in the peritoneal cavity of women following retrograde menstruation when endometrial fragments, fibrin, leucocytes and cytokines are trapped in pockets in the dependent parts of the pelvis, allowing endometrial cell proliferation, invasion and angiogenesis to occur. In the present review article, we will further discuss this in vitro model of early endometriosis and discuss possible anti-angiogenic drugs that are already commercially available in an attempt to find an effective and specific treatment for endometriosis.

Purpose The negative correlation between fecundity and age in women has been extensively documented although data on reproductive performance in very young women is sparse. The objective of this study was to determine whether age ≤25 years has an impact on reproductive outcome in women undergoing IVF-ET. Methods IVF outcome in 85 infertility patients aged 19-25 years was compared to that in 69 infertility patients aged 30-35 years. Primary outcomes included fertilization rates and embryo quality. Secondary outcomes were clinical pregnancy and miscarriage rates. Results The young patients (≤25 years) demonstrated a lower fertilization rate, and reduced number of top quality embryos. Although clinical pregnancy, and implantation rates were similar to their older counterparts (30-35 years), the young women had a significantly higher miscarriage rate. Conclusion Our results demonstrating poorer reproductive performance in very young patients were surprising and need further investigation.

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