Endometriosis and infertility

Abstract

Endometriosis is a debilitating condition characterized by high recurrence rates. The etiology and pathogenesis remain unclear. Typically, endometriosis causes pain and infertility, although 20-25% of patients are asymptomatic. The principal aims of therapy include relief of symptoms, resolution of existing endometriotic implants, and prevention of new foci of ectopic endometrial tissue. Current therapeutic approaches are far from being curative; they focus on managing the clinical symptoms of the disease rather than fighting the disease. Specific combinations of medical, surgical, and psychological treatments can ameliorate the quality of life of women with endometriosis. The benefits of these treatments have not been entirely demonstrated, particularly in terms of expectations that women hold for their own lives. Although theoretically advantageous, there is no evidence that a combination medical-surgical treatment significantly enhances fertility, and it may unnecessarily delay further fertility therapy. Randomized controlled trials are required to demonstrate the efficacy of different treatments.

Effects of infertility, pregnancy loss, and patient concerns on family size of women with rheumatoid arthritis and systemic lupus erythematosus

“…Medications, in particular nonsteroidal antiinflammatory drugs, may also play a role in infertility (17). Endometriosis was only reported in 10% of women with infertility, less than the rate expected in the general infertile population (25-50%) (18). While some prior studies have suggested an immunologic link between endometriosis and rheumatic disease, this is not supported by this study (19,20).…”

Analytical Hypotheses on Possible Etiology and Types of Endometriosis

“…Many studies have declared that the etiology and pathogenesis of endometriosis still remain unclear [9,48]. The description of "intermediate stage" in the malignant transformation of "atypical endometriosis" [49], which today is classified by the degree of dysplastic histologic atypia [50] perhaps supports the hypothesis of "endometroid endometriosis" as related to the malignant transformation, and that the hypothesized endometroid endometriosis cells are the "atypical endometriosis."…”

“…However, the absence of reliable non-invasive marker for the diagnosis of endometriosis makes the true prevalence problematic. Endometriosis is primarily found in young menstruating women, rarely observed before puberty, after menopause or in women with amenorrhea but its occurrence is not related to ethnic or social group distinctions Journal Of Prevention & Infection Control [9]. Endometriosis is often associated with chronic fatigue, acute abdomen and with dyspareunia and dysmenorrhea [10,11].…”

The combined approach (laparoscopy + dienogest) for endometrios-associated infertility treatment

“…Результаты многих исследований, сфокусиро-ванных на лечении эндометриоза, в зависимости от стадии противоречивы, даже при едином алгоритме лечения [23][24][25]. Очевидно, что пациентки с одина-ковой стадией заболевания, согласно классифика-ции ASRM, фактически несравнимы в проявлении симптомов и активности эндометриоза [7,26].…”