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Załęcka J, Zielińska Z, Ołdak Ł, Sakowicz A, Mańka G, Kiecka M, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Pierzyński P, Ciebiera M, Wojtyła C, Lipa M, Warzecha D, Wielgoś M, Cendrowski K, Gorodkiewicz E, Laudański P. The SPRi determination of cathepsin L and S in plasma and peritoneal fluid of women with endometriosis. Adv Med Sci 2024; 69:224-230. [PMID: 38642611 DOI: 10.1016/j.advms.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/26/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Endometriosis is a common disease with a complex pathomechanism and atypical symptoms, often leading to delayed diagnosis. Currently, the sole method for confirming the presence of the disease is through laparoscopy and histopathological examination of collected tissue. However, this invasive procedure carries potential risk and complications, necessitating the exploration of non-surgical diagnostic methods for endometriosis. This study aims to analyze peritoneal fluid and plasma samples for the expression of cathepsin L and cathepsin S to identify potential biomarkers for non-invasive diagnostic approaches to endometriosis. MATERIAL AND METHODS In this cross-sectional study, plasma and peritoneal fluid samples were obtained during laparoscopy from 63 patients diagnosed with chronic pelvic pain or infertility. The study group consisted of women with confirmed endometriosis. The concentrations of cathepsins L and S were determined using an SPRi biosensor. RESULTS The study did not reveal significant differences in the concentrations of cathepsin L and cathepsin S between the control group and the study group, both in peritoneal fluid and plasma. CONCLUSIONS Based on the results of this study, it appears that cathepsins L and S are not suitable candidates as biomarkers for endometriosis.
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Affiliation(s)
- Julia Załęcka
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Poland
| | - Zuzanna Zielińska
- Bioanalysis Laboratory, Doctoral School of Exact and Natural Science, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, Bialystok, Poland
| | - Łukasz Ołdak
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, Bialystok, Poland
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | | | | | - Robert Spaczyński
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, Poznan, Poland; Collegium Medicum, Institute of Health Sciences, University of Zielona Gora, Poland
| | - Piotr Piekarski
- Gynecological Obstetric Clinical Hospital of Poznan University of Medical Sciences, Minimally Invasive Gynecological Surgery, Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics Poznan University of Medical Sciences, Poland
| | - Artur Jakimiuk
- Department of Reproductive Health, Institute of Mother and Child in Warsaw, Warsaw, Poland; Department of Gynecology, Oncological Gynecology and Reproduction, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, Warsaw, Poland
| | - Jakub Młodawski
- Collegium Medicum Jan Kochanowski University in Kielce, Poland; Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland; Department of Surgical Gynecology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland; Department of Fetal Medicine and Gynecology, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetrics and Gynecology in Przemysl, Przemysl, Poland; Department of Obstetrics and Gynecology, University of Rzeszow, Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetrics and Gynecology in Przemysl, Przemysl, Poland; Department of Obstetrics and Gynecology, University of Rzeszow, Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | | | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postrgraduate Medical Education, Warsaw, Poland; Warsaw Institute of Women's Health, Warsaw, Poland
| | - Cezary Wojtyła
- OVIklinika Infertility Center, Warsaw, Poland; Women's Health Research Institute, Calisia University, Kalisz, Poland
| | - Michał Lipa
- Department of Obstetrics and Perinatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Damian Warzecha
- OVIklinika Infertility Center, Warsaw, Poland; City South Hospital Warsaw, Warsaw, Poland; Faculty of Medicine, University of Warsaw, Warsaw, Poland
| | - Mirosław Wielgoś
- Department of Obstetrics and Perinatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland; Premium Medical Clinic, Warsaw, Poland; Medical Faculty, Lazarski University, Warsaw, Poland
| | - Krzysztof Cendrowski
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Poland
| | - Ewa Gorodkiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, Bialystok, Poland
| | - Piotr Laudański
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Poland; OVIklinika Infertility Center, Warsaw, Poland; Women's Health Research Institute, Calisia University, Kalisz, Poland.
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Haddad RF, de Azevedo BC, de Mattos LA, Podgaec S. Nodular image in the appendix observed on ultrasound: endometriosis or neuroendocrine neoplasia? REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo1. [PMID: 38765516 PMCID: PMC11075395 DOI: 10.61622/rbgo/2024ao01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/21/2023] [Indexed: 05/22/2024] Open
Abstract
Objective To evaluate the association between clinical and imaging with surgical and pathological findings in patients with suspected neuroendocrine tumor of appendix and/or appendix endometriosis. Methods Retrospective descriptive study conducted at the Teaching and Research Institute of Hospital Israelita Albert Einstein, in which medical records and databases of patients with suspected neuroendocrine tumor of appendix and/or endometriosis of appendix were analyzed by imaging. Results Twenty-eight patients were included, all of which had some type of appendix alteration on the ultrasound examination. The pathological outcome of the appendix found 25 (89.3%) lesions compatible with endometriosis and three (10.7%) neuroendocrine tumors. The clinical findings of imaging and surgery were compared with the result of pathological anatomy by means of relative frequency. Conclusion It was possible to observe a higher prevalence of appendix endometriosis when the patient presented more intense pain symptoms. The image observed on ultrasound obtained a high positive predictive value for appendicular endometriosis.
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Affiliation(s)
- Raphael Federicci Haddad
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Bruna Cestari de Azevedo
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Leandro Accardo de Mattos
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Sergio Podgaec
- Hospital Israelita Albert EinsteinSão PauloSPBrazilHospital Israelita Albert Einstein, São Paulo, SP, Brazil.
- Universidade de São PauloFaculdade de MedicinaDepartamento de Obstetrícia e GinecologiaSão PauloSPBrazilDepartamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Mian DB, Loue V, Yao A, Koffi N, Serge B. Management of Isolated Umbilical Endometriosis in a Resource Limited Country: Two Cases and Review of the Literature. J Obstet Gynaecol India 2023; 73:451-454. [PMID: 37916046 PMCID: PMC10616011 DOI: 10.1007/s13224-023-01742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 02/05/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Dehi Boston Mian
- Department of Gynecology and Obstetrics, University Felix Houphouet Boigny of Cocody, Abidjan, Côte d’Ivoire
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Côte d’Ivoire
- Research Unit of Medical Sciences, University Felix Houphouet Boigny de Cocody, BP Abidjan 03, Abidjan, Côte d’Ivoire
- Unit of Gynecology and Obstetrics (GO) of University Hospital of Cocody, BP V 13, Abidjan, Côte d’Ivoire
| | - Vedi Loue
- Department of Gynecology and Obstetrics, University Felix Houphouet Boigny of Cocody, Abidjan, Côte d’Ivoire
| | - Alexis Yao
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Côte d’Ivoire
| | - N’guessan Koffi
- Department of Gynecology and Obstetrics, University Felix Houphouet Boigny of Cocody, Abidjan, Côte d’Ivoire
| | - Boni Serge
- Department of Gynecology and Obstetrics, University Felix Houphouet Boigny of Cocody, Abidjan, Côte d’Ivoire
- Department of Gynecology and Obstetrics, University Hospital of Cocody, Abidjan, Côte d’Ivoire
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Jin X, Feng J, Cheng X. LncRNA IGF2-AS promotes endometriosis progression through targeting miR-370-3p/IGF2 axis and activating PI3K/AKT/mTOR signaling pathway. J Assist Reprod Genet 2022; 39:2699-2710. [PMID: 36508036 PMCID: PMC9790843 DOI: 10.1007/s10815-022-02638-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/12/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Endometriosis, a gynecological disease, is difficult to be cured. Currently, to identify more potential biomarkers for the early diagnosis of endometriosis is urgently needed. Insulin like growth factor 2 (IGF2) has been revealed to correlate with endometriosis. This research aimed to further explore the role of IGF2 and its up-stream mechanism in endometriosis. METHODS Primary ectopic endometrial stromal cells (EESCs) were extracted from ectopic endometrial tissues which were pathological endometrial tissues resected from three patients with II-III endometriosis. Primary normal endometrial stromal cells (NESCs) were extracted from normal endometrial tissues of two patients with grade III cervical dysplasia and one patient with uterine leiomyoma III. Four endometriotic cell lines (EEC145T, hEM15A, hEM5B2, and 12Z) and normal human endometrial epithelial cells (hEECs) were purchased. Cell proliferation, migration, and invasion were evaluated through functional assays. The molecular interaction between RNAs was investigated through mechanistic analyses. RESULTS We discovered that IGF2 was upregulated in purchased endometriotic cells and primary EESC. Suppression of IGF2 hampered cell proliferation, migration, and invasion. Furthermore, insulin-like growth factor 2 antisense RNA (IGF2-AS) was uncovered to positively regulate IGF2 expression and enhanced proliferative, migratory, and invasive abilities of endometriotic cells. Mechanistically, miR-370-3p was found to bind with IGF2-AS and IGF2. IGF2-AS competitively bind with miR-370-3p to upregulate IGF2. Furthermore, IGF2-AS was revealed to activate the PI3K/AKT/mTOR signaling pathway through targeting miR-370-3p/IGF2 axis. CONCLUSION IGF2-AS promotes endometriotic cell growth via regulating IGF2/miR-370-3p axis and further activating PI3K/AKT/mTOR signaling pathway.
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Affiliation(s)
- Xiaoyan Jin
- VIP Ward, the First People's Hospital of Wenling, No.333, South Chuan'an Road, Chengxi Street, Wenling, 317500, China
| | - Jingjing Feng
- Department of Obstetrics and Gynecology, Nanjing Jiangbei People's Hospital, Nanjing, 210044, Jiangsu, China.
| | - Xiao Cheng
- VIP Ward, the First People's Hospital of Wenling, No.333, South Chuan'an Road, Chengxi Street, Wenling, 317500, China.
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Ye J, Peng H, Huang X, Qi X. The association between endometriosis and risk of endometrial cancer and breast cancer: a meta-analysis. BMC Womens Health 2022; 22:455. [PMID: 36401252 PMCID: PMC9673303 DOI: 10.1186/s12905-022-02028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Endometriosis (EMS) is confirmed pathophysiologically to be an estrogen-dependent disease, similar to endometrial hyperplasia/cancer and breast cancer. Epidemiological and biological data on endometriosis might explain links between endometriosis and these cancers. We sought to identify the differences in the risk of endometrial cancer and breast cancer between women with and women without endometriosis. METHODS We searched PubMed, EMBASE, the Cochrane Library, and four Chinese databases (CNKI, VIP, WanFang, CBM) to identify relevant studies published online between January 2011 and March 2021. In our meta-analysis, we used the Newcastle-Ottawa Scale (NOS) to evaluate the design and quality of all studies, and we calculated the pooled risk ratio (RR) using the random model. The Q test and I2 were used to evaluate the degree of heterogeneity of eligible studies. We used funnel plots and Begg's and Egger's tests to assess publication bias. RESULTS Of the 1369 articles, we finally included 14 cohort studies and seven case-control studies. Data from large cohort and case-control studies indicate that women with endometriosis had an increased risk of both endometrial cancer [RR, 1.662; 95% CI, (1.148-2.407)] and breast cancer [RR, 1.082; 95% CI, (1.001-1.169)]. CONCLUSION Endometriosis can increase the risk of endometrial cancer and breast cancer, and women with endometriosis are recommended to receive routine screening in long-term management.
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Affiliation(s)
- Jiatian Ye
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Hongling Peng
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xia Huang
- Department of Gynecology and Obstetrics, The Fourth People's Hospital, Zigong, People's Republic of China
| | - Xiaorong Qi
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China.
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Robot-assisted laparoscopy for deep infiltrating endometriosis: a retrospective French multicentric study (2008-2019) using the Society of European Robotic Gynecological Surgery endometriosis database. Arch Gynecol Obstet 2022; 305:1105-1113. [PMID: 35113234 DOI: 10.1007/s00404-022-06414-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 01/04/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aimed at assessing perioperative results of robot-assisted laparoscopy (RAL) in the context of deep infiltrating endometriosis (DIE). METHODS This retrospective French multicentric study included all patients with DIE who underwent surgical treatment managed by RAL (Da Vinci® System). From November 2008 to June 2019, patients were included in a single European database, in Robotic Assisted Laparoscopic Gynecologic Surgery, with Society of European Robotic Gynecological Surgery collaboration. Patients had different DIE sites as follows: gynecological, urological, or digestive, or combinations of these. Surgical procedures and perioperative complications were evaluated. To assess complications, patients were divided into the following four groups according to surgical procedure and DIE site: gynecological only; gynecological and urological; gynecological and digestive; and gynecological, urological, and digestive. RESULTS A total of 460 patients treated at one of eight health-care facilities from November 2008 to June 2019 were included. Median operative time was 245 min (IQR 186-320), surgeon console time was 138 ± 75 min and estimated blood loss was 70.0 mL ± 107 mL. Among this patient sample, 42.1% had a multidisciplinary surgical approach with a digestive or urology surgeon in addition to gynecology surgeon (25.5% and 16.6% of cases, respectively). Among those with intraoperative complications (n = 25, 5.4%) were primarily conversion to laparotomy (n = 6, 2.0%), transfusion (n = 2, 0.6%), and organ wounds (n = 8, 1.7%). Overall, 5.6% had severe postoperative complications (Clavien-Dindo classification ≥ Grade 3). CONCLUSION This is among the largest published series addressing RAL for DIE. Interest in this procedure appears promising, with no observed increases in blood loss or in peri- or post-operative complications. DIE laparoscopic surgery can require complex surgical procedures performed by multidisciplinary surgical teams. Thus, it may be one of the best candidates for RAL within gynecology surgery.
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Robin C, Uk A, Decanter C, Behal H, Collinet P, Rubod C, Barbotin AL, Robin G. Impact of endometriosis on oocyte morphology in IVF-ICSI: retrospective study of a cohort of more than 6000 mature oocytes. Reprod Biol Endocrinol 2021; 19:160. [PMID: 34656130 PMCID: PMC8522159 DOI: 10.1186/s12958-021-00798-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Infertility associated with endometriosis can be explained by several non-exclusive mechanisms. The oocyte plays a crucial role in determining embryonic competence and this is particularly relevant for in vitro fertilization (IVF) outcomes. According to some authors, the morphology of oocytes could also be a non-invasive marker of oocyte quality. The aim of this study was to evaluate the relationship between endometriosis and oocyte morphology after controlled ovarian stimulation for intracytoplasmic sperm injection (ICSI) on a large oocyte cohort. METHODS Single-center comparative retrospective study in the academic In Vitro Fertilization (IVF) unit of the Lille University Hospital. A total of 596 women treated for IVF-ICSI with ejaculated spermatozoa for sperm alterations were included. They were classified as endometriosis (n = 175) or control groups (n = 401). The morphological evaluation of 2,016 mature oocytes from 348 cycles of patients with endometriosis was compared with that of 4,073 mature oocytes from 576 control cycles. The main outcome measures were Average Oocyte Quality Index (AOQI) and metaphase II oocyte morphological scoring system (MOMS). Comparison of groups was carried out by a mixed linear model and by a generalized estimation equation model with a "patient" random effect to consider that a patient might have several attempts. RESULTS No difference in AOQI and MOMS scores was found between endometriosis and control women (adjusted p = 0.084 and 0.053, respectively). In case of endometriosis, there were significantly fewer metaphase II oocytes retrieved, embryos obtained, grade 1 embryos and number of cumulative clinical pregnancies compared to controls. In the endometriosis group, endometriosis surgery was associated with a reduced number of mature oocytes retrieved, and the presence of endometrioma(s) was associated with some abnormal oocyte shapes. Nevertheless, no difference concerning the AOQI and MOMS scores was found in these subgroups. CONCLUSION Endometriosis does not have a negative impact on oocytes' morphology in IVF-ICSI. TRIAL REGISTRATION On December 16, 2019, the Institutional Review Board of the Lille University Hospital gave unrestricted approval for the anonymous use of all patients' clinical, hormonal and ultrasound records (reference DEC20150715-0002).
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Affiliation(s)
- Camille Robin
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France.
| | - Audrey Uk
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
| | - Christine Decanter
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
| | - Hélène Behal
- EA 2694, Santé Publique : Épidémiologie Et Qualité Des Soins, Univ. Lille, CHU Lille, Unité de Biostatistiques, F-59000, Lille, France
| | - Pierre Collinet
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Chrystèle Rubod
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Anne-Laure Barbotin
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Centre Hospitalier Et Universitaire, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
| | - Geoffroy Robin
- Service de Gynécologie Endocrinienne Et Médecine de La Reproduction, CHU Lille, Assistance Médicale À La Procréation Et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Service dAvenue Eugène Avinée, 59000, Lille, France
- EA 4308 Gamètogenèse Et Qualité du Gamète, Faculté de Médecine Et CHU de Lille, F-59000, Lille, France
- Faculté de Médecine, Université de Lille, 59045, Lille, France
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Parra RS, Feitosa MR, Biagi GBB, Brandão DF, Moraes MMFDS, Silvestre L, Zanardi JVC, Sato Junior NH, Féres O, da Rocha JJR. Neuroendocrine appendiceal tumor and endometriosis of the appendix: a case report. J Med Case Rep 2020; 14:152. [PMID: 32921300 PMCID: PMC7489048 DOI: 10.1186/s13256-020-02490-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/07/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Endometriosis of the appendix is very uncommon, accounting for only about 1% of all cases of endometriosis. However, endometriosis is found in the appendix in approximately 8-13% of patients with deep infiltrating endometriosis and is particularly common in patients with severe forms of deep infiltrating endometriosis. Neuroendocrine tumors are the most common neoplasms of the appendix and may be misdiagnosed when there are multiple endometriosis lesions in the pelvis. CASE PRESENTATION We describe a case of a Caucasian patient with deep infiltrating endometriosis with rectal involvement, retrocervical lesions, and a right ovarian endometrioma with no suspected lesions in the appendix. She underwent laparoscopy and, after a systematic intraoperative evaluation, suspected involvement of the appendix was observed. The patient underwent ovarian cystectomy, excision of the pelvic endometriosis lesions, appendectomy, and anterior stapler discoid resection. Histopathological analysis of the appendix revealed endometriosis and a well-differentiated neuroendocrine carcinoma at the appendix tip. DISCUSSION Our patient's case emphasizes the need to approach these lesions carefully and strengthens the indication for appendectomy when the appendix is affected in the setting of endometriosis. Despite the more likely diagnosis of appendiceal endometriosis, neuroendocrine tumors cannot be ruled out by imaging examinations, and both conditions can occur in the same patient.
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Affiliation(s)
- Rogério Serafim Parra
- Proctogastroclinic, Eliseu Guilherme St, 09, Ribeirão Preto, SP, Brazil. .,Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil.
| | - Marley Ribeiro Feitosa
- Proctogastroclinic, Eliseu Guilherme St, 09, Ribeirão Preto, SP, Brazil.,Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | | | | | | | | | | | | | - Omar Féres
- Proctogastroclinic, Eliseu Guilherme St, 09, Ribeirão Preto, SP, Brazil.,Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
| | - José Joaquim Ribeiro da Rocha
- Proctogastroclinic, Eliseu Guilherme St, 09, Ribeirão Preto, SP, Brazil.,Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, Sao Paulo, Brazil
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Murji A, Biberoğlu K, Leng J, Mueller MD, Römer T, Vignali M, Yarmolinskaya M. Use of dienogest in endometriosis: a narrative literature review and expert commentary. Curr Med Res Opin 2020; 36:895-907. [PMID: 32175777 DOI: 10.1080/03007995.2020.1744120] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: Endometriosis affects up to 10% of women of reproductive age, and the main goal of treatment is to relieve symptoms. Progestins have been the mainstay of endometriosis suppression, of which dienogest has become an important option in many parts of the world. This is an expert literature review, with recommendations on the use of dienogest in the context of various clinical considerations when treating endometriosis.Methods: A search of PubMed was conducted for papers published between 2007 and 2019 on the use of dienogest in endometriosis. Experts reviewed these and included those they considered most relevant in clinical practice, according to their own clinical experience.Results: Evidence regarding the long-term use (>15 months) of dienogest for the management of endometriosis is presented, with experts concluding that the efficacy of dienogest should be assessed primarily on its impact on pain and quality of life. Fertility preservation, the option to avoid or delay surgery, and managing bleeding irregularities that can occur with this treatment are also considered. Counseling women on potential bleeding risks before starting treatment may be helpful, and evidence suggests that few women discontinue treatment for this reason, with the benefits of treatment outweighing any impact of bleeding irregularities.Conclusions: Overall, the evidence demonstrates that dienogest offers an effective and tolerable alternative or adjunct to surgery and provides many advantages over combined hormonal contraceptives for the treatment of endometriosis. It is important that treatment guidelines are followed and care is tailored to the woman's individual needs and desires.
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Affiliation(s)
- Ally Murji
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | | | - Jinhua Leng
- Peking Union Medical College Hospital, Beijing, China
| | - Michael D Mueller
- Department of Obstetrics and Gynecology, University Hospital of Bern and University of Bern, Bern, Switzerland
| | - Thomas Römer
- Department of Obstetrics and Gynecology, Academic Hospital of Obstetrics and Gynecology, University of Cologne, Cologne, Germany
| | - Michele Vignali
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Maria Yarmolinskaya
- Department of Gynecological Endocrinology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russia
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Carneiro MM, Farace BL, Ribeiro LSDC, Silverio RCCC, Moreira T, Filho ALDS, Baroni ALLR, Ferreira MCF. Using social media to educate women and healthcare providers on endometriosis: preliminary results. JBRA Assist Reprod 2020; 24:9-12. [PMID: 31361436 PMCID: PMC6993160 DOI: 10.5935/1518-0557.20190048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: This study aimed to evaluate the performance of our Facebook fan page and compare it to similar pages. Methods: The authors reviewed page-specific metrics provided by Facebook, including number of fans, their age and sex, and country of origin; number of views, likes, and shares tied to our posts. A search for similar fan pages using keyword "endometriosis" found pages in Portuguese, English, and Spanish. They were analyzed for country of origin, authors, number of fans and posts, and were compared to our page. Results: Our fan page went online on April 2016 and 127 posts have been published up to December 2017. Most of its 1746 fans (89% women; 11% men) were Brazilians (n=1677). Our audience comprised primarily women aged 25-34 (39%) and 35-44 (30%) years. The most viewed posts discussed thrombosis and oral contraceptives (n =11078); continuous use of oral contraceptives (n=6448); deep endometriosis (n=4425); intrauterine levonorgestrel system (n=4045); IVF and endometriosis (n=2885); and endometriosis and cancer (n=2431). Our search found 399 Facebook pages from 44 different countries. The United States (n=81), Brazil (n=49), and the United Kingdom (n=46) topped the list of countries hosting pages, while most of the fan pages were written in English. The majority of the pages were active and 20% claimed they were based on science. Physicians administered four of the 10 most popular pages. Page heterogeneity prevented comparisons between them. Conclusion: Men and women have visited our Facebook fan page to obtain information on endometriosis. The pages found in our search were exceedingly heterogeneous and were not compared. Developing pages with sound information is an important step toward educating individuals about endometriosis and helping them make informed choices on available treatments.
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Affiliation(s)
- Márcia Mendonça Carneiro
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil.,Multidisciplinary Endometriosis Team. Hospital Biocor and Mater Dei Hospitals - Belo Horizonte - MG - Brazil
| | - Barbara Lopes Farace
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Luisa Silva de Carvalho Ribeiro
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Raphaela Cristina Conrado C Silverio
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Thais Moreira
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Agnaldo Lopes da Silva Filho
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Ana Luiza Lunardi Rocha Baroni
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
| | - Márcia Cristina França Ferreira
- Department of Gynecology and Obstetrics. School of Medicine of the Federal University of Minas Gerais. Belo Horizonte, Minas Gerais, Brazil.,Multidisciplinary Endometriosis and Chronic Pelvic Pain Team. Hospital das Clínicas da UFMG. Belo Horizonte - MG - Brazil
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11
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Toullec L, Batteux F, Santulli P, Chouzenoux S, Jeljeli M, Belmondo T, Hue S, Chapron C. High Levels of Anti-GM-CSF Antibodies in Deep Infiltrating Endometriosis. Reprod Sci 2020; 27:211-217. [PMID: 32046390 DOI: 10.1007/s43032-019-00021-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/25/2019] [Indexed: 12/19/2022]
Abstract
Endometriosis is a chronic hormono-dependent inflammatory gynecological disease. Endometriosis can be subdivided into three forms: superficial peritoneal implants, endometrioma, and deep infiltrating endometriosis (DIE). Inflammation is a typical feature of endometriosis with overproduction of prostaglandins, chemokines, and cytokines, like granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF is a hematopoietic growth factor and immune modulator which belongs to the group of cytokines that actively participate in inflammatory reactions. GM-CSF autoantibodies (Ab) are described in inflammatory diseases such as Crohn disease and ulcerative colitis where high concentrations of anti-GM-CSF Ab are correlated with severity, complications, and relapses. We have evaluated the presence of anti-GM-CSF Ab in the serum of 106 patients with endometriosis and 92 controls using a home-made enzyme-linked immunosorbent assay (ELISA) and correlated the results with the form and severity of the disease. We found that anti-GM-CSF Ab level is significantly increased in the sera of patients with endometriosis compared to controls and is associated with the severity of the disease especially in patients with deep endometriosis (p < 0.0001) with the highest number of lesions (p = 0.0034), including digestive involvement (p = 0.0041). We also found a correlation between these levels of anti-GM-CSF Ab and the number of lesions in DIE patients (r = 0.913). In this way, searching anti-GM-CSF Ab in endometriosis patient sera could be of value for patient follow-up and put further insight into the role of inflammation and of GM-CSF in endometriosis pathogenesis.
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Affiliation(s)
- Laurie Toullec
- Department of Immunology, Cochin University Hospital, APHP, Paris, France.,Department of Immuno-hematology, Henri Mondor University Hospital, APHP, Créteil, France
| | - Frédéric Batteux
- Department of Immunology, Cochin University Hospital, APHP, Paris, France. .,INSERM U1016, Institut Cochin, Paris, France.
| | - Pietro Santulli
- Department of Gynecology Obstetrics II and Reproductive Medicine, Cochin University Hospital, Paris, France.,INSERM U1016, Institut Cochin, Paris, France
| | | | - Mohamed Jeljeli
- Department of Immunology, Cochin University Hospital, APHP, Paris, France.,INSERM U1016, Institut Cochin, Paris, France
| | - Thibaut Belmondo
- Department of Immuno-hematology, Henri Mondor University Hospital, APHP, Créteil, France
| | - Sophie Hue
- Department of Immuno-hematology, Henri Mondor University Hospital, APHP, Créteil, France.
| | - Charles Chapron
- Department of Gynecology Obstetrics II and Reproductive Medicine, Cochin University Hospital, Paris, France. .,INSERM U1016, Institut Cochin, Paris, France.
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12
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Markham R, Luscombe GM, Manconi F, Fraser IS. A detailed profile of pain in severe endometriosis. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2019. [DOI: 10.1177/2284026519838948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To investigate the detailed nature of pain symptoms reported by women with endometriosis and those without current gynecological complaint. Design: Self-administered cross-sectional study was conducted using a structured questionnaire. Setting: Teaching hospital clinic, specialist gynecologist, and family practice patients; endometriosis community support group members; and university staff and students. Subjects: A total of 737 women returned completed surveys: women with endometriosis ( n = 529) and with no current gynecological complaint ( n = 208). Intervention(s): None. Main outcome measure(s): Demographics, experience of pain symptoms: frequency, severity, and characteristics. Results: All pain symptoms were significantly more common among women with endometriosis compared with controls. Women with endometriosis all reported experiencing dysmenorrhea to some degree ( N = 527, two missing), although the severity was “slight” for 5%. Dyspareunia was reported by 92% of women with endometriosis, most commonly during intercourse, rather than at the start or post-coital. The other pain symptoms experienced by women with endometriosis, in order of frequency, were lower back pain (93%), pain at ovulation (87%), pelvic pain other than during menses, ovulation, urination or intercourse (79%), dysuria (71%), and rectal pain (67%). The great majority of women with endometriosis reported multiple sources and types of pain. Among women with endometriosis there were clear associations between the severity of dysmenorrhea and the frequency of experiencing dyspareunia and other pain symptoms. Conclusion: Pain symptoms in women with endometriosis were generally much more extensive and complex than recognized by most clinicians.
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Affiliation(s)
- Robert Markham
- Department of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Georgina M Luscombe
- Department of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Frank Manconi
- Department of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ian S Fraser
- Department of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Women’s and Children’s Health, UNSW Sydney, Sydney, NSW, Australia
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13
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Sperschneider ML, Hengartner MP, Kohl-Schwartz A, Geraedts K, Rauchfuss M, Woelfler MM, Haeberlin F, von Orelli S, Eberhard M, Maurer F, Imthurn B, Imesch P, Leeners B. Does endometriosis affect professional life? A matched case-control study in Switzerland, Germany and Austria. BMJ Open 2019; 9:e019570. [PMID: 30782670 PMCID: PMC6340011 DOI: 10.1136/bmjopen-2017-019570] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Endometriosis is a gynaecological disease most commonly causing severe and chronic pelvic pain as well as an impaired quality of life. The aim of this study was to investigate if and how endometriosis affects choices regarding professional life as well as the quality of daily working life. DESIGN, SETTING AND PARTICIPANTS In the context of a multicentre case-control study, we collected data from 505 women with surgically/histologically confirmed diagnosis of endometriosis and 505 matched controls. Study participants were recruited prospectively in hospitals and doctors' practices in Switzerland, Germany and Austria. Using a detailed questionnaire, the study investigated work-life and career choices of study participants. MAIN OUTCOME MEASURES Associations between endometriosis/disease symptoms and limitations in career development as well as ability to work. RESULTS Women with endometriosis were less often able to work in their desired profession than women from the control group (adjusted OR=1.84, 95% CI: 1.15 to 2.94, R2=0.029, p=0.001) and they had to take health-related limitations into consideration in their career decisions to a significantly higher degree than women in the control group (OR=4.79, 95% CI: 2.30 to 9.96, R2=0.063, p<0.001). Among women with endometriosis, chronic pain was significantly associated with increased sick leave (OR=3.52, 95% CI: 2.02 to 6.13, R2=0.072, p<0.001) as well as with loss of productivity at work (OR=3.08, 95% CI: 2.11 to 4.50, R2=0.087, p<0.001). CONCLUSIONS Endometriosis is associated with impairment of professional life, in particular with regard to career choices. Further research to develop strategies to support endometriosis-affected women in realising professional opportunities is recommended. TRIAL REGISTRATION NUMBER NCT02511626; Pre-results.
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Affiliation(s)
- Marita Lina Sperschneider
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- Department of Gynaecology and Obstetrics, Canton Hospital Schaffhausen, Schaffhausen, Switzerland
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Alexandra Kohl-Schwartz
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- Division of Gynecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern, Switzerland
| | - Kirsten Geraedts
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | | | - Monika Martina Woelfler
- Department of Gynaecology, Endocrinology and Reproductive Medicine, Medical University Graz, Graz, Austria
| | - Felix Haeberlin
- Department of Gynaecology and Obstetrics, Canton Hospital St. Gallen, St. Gallen, Switzerland
| | - Stephanie von Orelli
- Department of Gynecology and Obstetrics, Triemli Hospital Zurich, Zurich, Switzerland
| | - Markus Eberhard
- Department of Gynaecology and Obstetrics, Canton Hospital Schaffhausen, Schaffhausen, Switzerland
| | - Franziska Maurer
- Department of Gynecology and Obstetrics, Canton Hospital Solothurn, Solothurn, UK
| | - Bruno Imthurn
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Imesch
- Department of Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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14
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Vassilopoulou L, Matalliotakis M, Zervou MI, Matalliotaki C, Spandidos DA, Matalliotakis I, Goulielmos GN. Endometriosis and in vitro fertilisation. Exp Ther Med 2018; 16:1043-1051. [PMID: 30116357 PMCID: PMC6090275 DOI: 10.3892/etm.2018.6307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 06/13/2018] [Indexed: 01/06/2023] Open
Abstract
The aim of the present review was to discuss a matter of concern in the clinical field of obstetrics/gynecology, namely the potency of in vitro fertilization (IVF) in the management of endometriosis-associated infertility. Endometriosis is a medical condition affecting one tenth of women in their fertile years, and accounts for up to 50% of infertile women. Thus, such high prevalence has established the necessity for investigating the effectiveness of available techniques in eradicating the disease and constraining infertility as well as the accompanying pain symptoms of endometriosis. The underlying mechanisms connecting endometriosis with low fecundity have been extensively studied, both in terms of genetic alterations and epigenetic events that contribute to the manifestation of an infertility phenotype in women with the disease. Several studies have dealt with the impact of IVF in pregnancy rates (PRs) on patients with endometriosis, particularly regarding women who wish to conceive. Results retrieved from studies and meta-analyses depict a diverse pattern of IVF success, underlining the involvement of individual parameters in the configuration of the final outcome. The ultimate decision on undergoing IVF treatment should be based on objective criteria and clinicians' experience, customized according to patients' individual needs.
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Affiliation(s)
- Loukia Vassilopoulou
- Laboratory of Forensic Sciences and Toxicology, Medical School, University of Crete, Heraklion 71409, Crete, Greece
| | - Michail Matalliotakis
- Department of Obstetrics and Gynecology, Venizeleio and Pananio General Hospital of Heraklion, Heraklion 71409, Crete, Greece
| | - Maria I Zervou
- Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion 71003, Crete, Greece
| | - Charoula Matalliotaki
- Department of Obstetrics and Gynecology, Venizeleio and Pananio General Hospital of Heraklion, Heraklion 71409, Crete, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Crete, Greece
| | - Ioannis Matalliotakis
- Department of Obstetrics and Gynecology, Venizeleio and Pananio General Hospital of Heraklion, Heraklion 71409, Crete, Greece
| | - George N Goulielmos
- Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion 71003, Crete, Greece
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