Kanellopoulos Dimitrios, Karagianni Dimitra, Pergialiotis Vasilios, Nikiteas Nikolaos, Lazaris Andreas C, Iliopoulos Dimitrios
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, Greece.
1st Department of Pathology, National and Kapodistrian University of Athens, Greece.
Maedica (Bucur). 2022 Jun;17(2):458-463. doi: 10.26574/maedica.2022.17.2.458.
Endometriosis is a condition that mainly concerns women of reproductive age, which causes several problems, including subfertility. The phenotypic presentation of endometriosis is defined by a complex interplay between genetic profile, immunological and mechanical factors. In this literature review we examine the causality between endometriosis and subfertility, outlining possible mechanisms involved in the pathogenesis. The purpose of this study was to conduct a literature review in order to identify the correlation between endometriosis and subfertility through possible mechanisms involved in the pathogenesis of endometriosis-associated subfertility and treatment. A search in Medline/PubMed was done, using the terms "endometriosis" and "subfertility", to identify the most relevant studies that were published during the last six years. Pathogenesis of endometriosis-associated subfertility is not clear yet, although some data indicate that there are several factors that could affect a patient's fertility. Involved mechanisms include mechanical obstruction such as ovarian tubal dysfunction and the abnormal peritoneal microenvironment, genetic, and epigenetic mechanisms, and immunological traits. It is fundamental to better understand these mechanisms in order to improve the therapeutic approach. The clinical management of endometiosis-related subfertility has to be improved. It is important to consider a change in the classification of endometriosis and, more importantly, an effort to avoid surgical procedures. There is a crucial need for effective protocols and novel targets for specific diagnosis and treatment. Consequently, the importance of understanding pathogenesis and genetic mechanisms is underlined. Future researchers should focus on novel non-invasive treatment methods that target specific pathogenic pathways.
子宫内膜异位症是一种主要影响育龄女性的疾病，会引发包括生育力低下在内的多种问题。子宫内膜异位症的表型表现由基因谱、免疫和机械因素之间的复杂相互作用所决定。在这篇文献综述中，我们研究了子宫内膜异位症与生育力低下之间的因果关系，概述了发病机制中可能涉及的机制。本研究的目的是进行一项文献综述，以通过子宫内膜异位症相关性生育力低下发病机制及治疗中可能涉及的机制，确定子宫内膜异位症与生育力低下之间的相关性。我们在Medline/PubMed中进行了检索，使用“子宫内膜异位症”和“生育力低下”等关键词，以找出过去六年中发表的最相关研究。子宫内膜异位症相关性生育力低下的发病机制尚不清楚，尽管一些数据表明有几个因素可能会影响患者的生育能力。涉及的机制包括机械性梗阻，如卵巢输卵管功能障碍和异常的腹膜微环境、遗传和表观遗传机制以及免疫特征。更好地理解这些机制对于改进治疗方法至关重要。子宫内膜异位症相关性生育力低下的临床管理必须得到改善。重要的是要考虑改变子宫内膜异位症的分类，更重要的是，要努力避免手术。迫切需要有效的方案和针对特定诊断和治疗的新靶点。因此，强调了理解发病机制和遗传机制的重要性。未来的研究人员应专注于针对特定致病途径的新型非侵入性治疗方法。
