“…3,12 Such anomalies, directly or indirectly, may account for impaired follicular growth, reduced dominant follicle size, fewer mature ovarian follicles, and decreased ovulation in women with endometriosis. 6,9,12,13 The process of ovulation is normally controlled through multiple temporal inputs, including protein and steroid hormones, metabolic signals, intrafollicular paracrine factors from the theca, mural, and cumulus granulosa cells and the oocyte. 14 Animal models replicating signs and symptoms of human disease have provided opportunities for in-depth characterization of mechanisms involved in the process of ovulation in women with endometriosis.…”