World Endometriosis Society consensus on the classification of endometriosis

Johnson, Neil; Hummelshøj, Lone; Adamson, G. David; Keckstein, J.; Taylor, Hugh S.; Abrão, Maurício Simões; Bush, Deborah; Kiesel, L.; Tamimi, Rulla M.; Sharpe-Timms, Kathy L.; Rombauts, Luk; Giudice, Linda C.

doi:10.1093/humrep/dew293

Cited by 526 publications

(427 citation statements)

References 14 publications

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“…Although the rAFS score is the prevailing endometriosis staging system, it has poor correlation with fertility outcomes [24]. While deep infiltrating endometriosis is indicative of poor future fertility [17], it does not adequately describe deep infiltrating endometriosis [24].…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Use of the Endometriosis Fertility Index to Predict Natural Pregnancy after Endometriosis Surgery: A Single-Center Study

Kim

Lee

Yun

et al. 2018

Gynecol Obstet Invest

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Aims: Our objective was to predict natural pregnancy after endometriosis surgery using the endometriosis fertility index (EFI). Methods: A retrospective medical records review was conducted, examining patients surgically treated for endometriosis at a single center in Korea between January 2009 and February 2015. In total, 68 women attempting natural conception were analyzed by assessing age, preoperative serum CA-125, body mass index, revised American Fertility Society (rAFS) stage, EFI, and pregnancy outcome. Kaplan-Meier estimates and log-rank tests were used to generate cumulative natural pregnancy rate curves based on an EFI cut-point. A receiver-operating characteristic (ROC) curve was plotted for EFI. Results: Seventy-seven patients attempted conceptions, resulting in 33 natural and 9 assisted conceptions. Excluding assisted conceptions, the mean EFI scores of 68 women who were not pregnant and pregnant were 5.43 ± 0.36 and 6.88 ± 0.28 respectively. The relation between EFI and natural pregnancy was significant (cumulative overall pregnancy rate, p = 0.006), whereas rAFS stage was not (univariate logistics, p = 0.853). The cut-point for maximum natural pregnancy outcomes was 6 (area under ROC curve = 0.710, 95% CI 0.586–0.835). Conclusion: The EFI is a reliable staging system for predicting natural pregnancy after endometriosis surgery. EFI scores can be used to guide postoperative treatment of women with endometriosis.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…While deep infiltrating endometriosis is indicative of poor future fertility [17], it does not adequately describe deep infiltrating endometriosis [24]. The EFI scoring system emerged as a useful method to predict spontaneous conception after endometriosis surgery [12].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Use of the Endometriosis Fertility Index to Predict Natural Pregnancy after Endometriosis Surgery: A Single-Center Study

Kim

Lee

Yun

et al. 2018

Gynecol Obstet Invest

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“…1,2 External endometrial lesions are frequently found in the pelvic peritoneum (extra-genital endometriosis) and ovaries (ovarian cyst or superficial heterotopies). Most often, external endometriosis is located on the peritoneal surface of the recto-vaginal space: at the retrocervical area, on the uterosacral ligaments and in the recto-sigmoid region of the colon.…”

Section: Introductionmentioning

confidence: 99%

“…Rarely, endometriosis is recognized in other extra abdominal organs, such as the brain and oculus. 1,2 Internal endometriosis (adenomyosis) is characterized by the presence of heterotopic endometrial glands and stroma in the uterine intramural muscular layer (deep in the myometrium) and is surrounded by reactive fibrosis of the myocytes. For a review see refs.…”

Section: Introductionmentioning

confidence: 99%

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Endometriosis origin from primordial germ cells

Makiyan

2017

Organogenesis

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ABSTRACT. Endometriosis is defined by the presence of endometrial ectopia. Multiple hypotheses have been postulated to explain the etiology of endometriosis to understand various clinical evidences. The etiology of endometriosis is still unclear.The primary question to understanding the etiology of endometrial ectopia (endometriosis) is determining the origin of eutopic (normally cited) endometrium.According to the new theory, primordial germ cells migrate from hypoblast (yolk sac close to the allantois) to the gonadal ridges. The gonadal ridges which composed of primordial germ cells derive to the: eutopic endometrium, ovary, ovarian ligament and ligamentum teres uteri.There are 2 principal processes in uterine organogenesis: the intersection of gonadal ridges with mesonephral ducts to form the uterine folds with an endometrial cavity and the fusion of the both uterine folds together to form the unicavital (normal) uterus. In the uterine folds there are closer cell-to-cell communications, polypotential germ cells differentiate and grow into myometrium and endometrial layers.Some of the polypotential germ cells fail to reach the ridges and stay in the peritoneal cavity, where they may be transforming into external endometrial heterotopies.The main insight in the etiology of endometriosis is polypotential germ cells origin, which may explain its potency, pathogenesis and expansion.

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