Endometriosis and Subfertility: Is the Relationship Resolved?

D’Hooghe, Thomas; Debrock, Sophie; Hill, Joseph A.; Meuleman, Christel

doi:10.1055/s-2003-41330

Cited by 259 publications

(56 citation statements)

References 64 publications

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“…It is common in women with subfertility and can affect fertility at different levels, from the induction of a local inflammation and decrease in endometrial receptivity to mechanical obstruction and altered sexual function. Endometriosis is more prevalent among women with subfertility (up to 50%) than among women with proven fertility (5-10%) [1]. Moreover, the monthly fecundity rate is lower among women with endometriosis (2-10%) than among fertile women (15-20%) [2].…”

Section: Introductionmentioning

confidence: 99%

Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

Zeng¹,

Xu²,

Zhou³

et al. 2014

Gynecol Obstet Invest

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Background/Aims: To determine whether the revised American Fertility Society (rAFS) classification and endometriosis fertility index (EFI) predict pregnancy rates (PRs) in patients with surgically confirmed endometriosis attempting natural conception. Methods: We retrospectively assessed 194 women with endometriosis who underwent laparoscopic surgery; 161 women completed the follow-up. Pregnancy outcomes, rAFS stages and EFI scores were documented. Cumulative PRs were compared using Kaplan-Meier survival analysis. Results: The cumulative PR 36 months after surgery was 46.6% (stage I, 53.6%; stage II, 36.0%; stage III, 51.7%, and stage IV, 41.7%; log-rank test, χ² = 4.143, p = 0.246). In the 1st year, PRs significantly differed between patients with rAFS stage IV and those with stages I-III (Pearson's χ² test, χ² = 6.024, p = 0.014). Significant differences in cumulative PRs were observed among EFI scores (group 1, EFI score 0-3, 8.3%; group 2, EFI score 4-7 41.2%, and group 3, EFI score 8-10 60.9%; log-rank test, χ² = 16.254, p < 0.001). Conclusions: EFI scores, but not rAFS stage, predict PRs in patients with endometriosis-associated infertility. EFI scores may be used to guide postoperative treatment.

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Section: Introductionmentioning

confidence: 99%

Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

Zeng¹,

Xu²,

Zhou³

et al. 2014

Gynecol Obstet Invest

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“…It is characterized by the growth of endometrial tissue outside the uterine cavity and can result in severe pelvic pain (Evans et al 2007) and subfertility (D'Hooghe et al 2003). Currently, the most widely accepted theory of endometriosis etiology purports that retrograde menstruation allows the implantation of viable endometrial cells at ectopic sites (Sampson 1927, Halme et al 1984.…”

Section: Introductionmentioning

confidence: 99%

Glucose transporter expression in eutopic endometrial tissue and ectopic endometriotic lesions

McKinnon¹,

Bertschi²,

Wotzkow³

et al. 2014

Journal of Molecular Endocrinology

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Endometriosis is an extremely prevalent disorder characterized by the growth of endometrial tissue at ectopic locations. Glycolysis is an energy-producing mechanism that occurs in almost all cells and requires an adequate uptake of glucose mediated by glucose transporter (GLUT) proteins. At present, however, very little is known about their expression in either the endometrium or the endometriotic lesions. The objective of this study was to examine the expression of SLC2A genes in the endometrium of women with and without endometriosis and in the matching ectopic tissue, and to confirm the presence of the GLUT proteins in ectopic lesions. There was a significantly higher expression of SLC2A3 and a significantly lower expression of SLC2A4 in women with endometriosis compared with those without. In women with endometriosis, the ectopic expression of SLC2A3, SLC2A4 and SLC2A5 was significantly higher than that observed in the matching eutopic tissue. GLUT1 protein expression was present in both epithelial and stromal cells and GLUT3 was confined to CD45-positive leukocytes. GLUT4 expression was strong in both ectopic epithelial and stromal cells and localized to the cellular membrane in epithelial cells. These results show that GLUT expression is altered between eutopic and ectopic tissue and between women with and without endometriosis, and that GLUT4 may represent a significant entry route for glucose into the endometriotic epithelial cells. The inducible nature of GLUT4 and its limited cellular expression may make GLUT4 an attractive target for non-hormone-based treatments of endometriosis.

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“…More precise data are, however, not available, as not all women with endometriosis are symptomatic, and therefore they are not laparoscopically diagnosed with endometriosis [2,3]. The fact that the time interval from the onset of symptoms (e.g.…”

Section: Introductionmentioning

confidence: 99%

Neuroimmunomodulatory Alterations in Non-Lesional Peritoneum Close to Peritoneal Endometriosis

Arnold¹,

Vercellino²,

Chiàntera³

et al. 2012

Neuroimmunomodulation

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Objectives: An imbalance in the ratio of sensory to sympathetic nerve fibre (NF) density in peritoneal endometriotic lesions (pEL) has recently been demonstrated and leads to the assumption that this preponderance of the sensory pro-inflammatory milieu is a major cause of pain in endometriosis. Therefore, the density of sensory and sympathetic NFs was determined in distal unaffected peritoneum of endometriosis patients to be able to detect possible alterations in unaffected peritoneum. Methods: In serial pEL sections (n = 40), lesional and matching unaffected peritoneum as well as healthy peritoneum (HP) from patients without endometriosis (n = 15) were immunohistochemically analysed to identify protein gene product 9.5-, substance P- and tyrosine hydroxylase-positive NFs (intact, sensory and sympathetic NFs, respectively). In addition, the amount of immune cell infiltrates and the expression of nerve growth factor (NGF) and interleukin (IL)-1β in nerves of peritoneal endometriotic specimens were compared to those in the HP. Results: The overall NF density in the non-lesional, unaffected peritoneum of endometriosis patients is significantly reduced in comparison to both HP and pEL, while sensory NFs remain the same; the sympathetic NF density is significantly decreased compared to HP, but is still higher than the density close to the pEL. Immune cell infiltrates as well as NGF and IL-1β expression in nerves is significantly elevated in distal unaffected peritoneum in comparison to HP. Conclusion: The altered NF density in the non-lesional, unaffected peritoneum of endometriosis patients suggests new aspects in the understanding of the development of endometriosis and pain management in endometriosis.

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Endometriosis and Subfertility: Is the Relationship Resolved?

Cited by 259 publications

References 64 publications

Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

Reproductive Performance after Surgery for Endometriosis: Predictive Value of the Revised American Fertility Society Classification and the Endometriosis Fertility Index

Glucose transporter expression in eutopic endometrial tissue and ectopic endometriotic lesions

Neuroimmunomodulatory Alterations in Non-Lesional Peritoneum Close to Peritoneal Endometriosis

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