Role of eutopic endometrium in pelvic endometriosis
Abstract
Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is considered a benign gynecologic condition; however, in some cases, it may be aggressive. The pathogenesis of endometriosis is complex and multifactorial. Despite being one of the most widely studied gynecologic diseases, its pathogenesis remains uncertain. The intrinsic endometrial abnormalities thought to be associated with endometriosis include abnormal expression of genes, modification of endometrial response to hormones such as progesterone; increased nerve density, and oxidative stress. Evaluation of the endometrium in patients with endometriosis is an important line of investigation in the pathophysiology of the disease. It has been suggested that investigation of eutopic endometrium may help to achieve this goal. Presented herein is a literature review and a comprehensive evaluation of the role of eutopic endometrium in pelvic endometriosis. Clinical correlations of the disease are highlighted, with the objective of understanding the role of eutopic endometrium in endometriosis.
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In the endometrium of women with endometriosis, several hundred minor biochemical changes have been described.
“In the endometrium of women with endometriosis several hundred minor biochemical changes have been described (124-128).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [124]
More than 200 differences between the endometrium of women with and without endometriosis have been described.
“More than 200 differences between the endometrium of women with and without endometriosis were described (for recent reviews, see Refs.[169][170][171][172][173]).”
From Pathogenesis of deep endometriosis (2017) · cites this paper as [169]
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Pathogenesis of endometriosis: The genetic/epigenetic theory
Koninckx, P. R., Ussia, A., Adamyan, L., Wattiez, A., Gomel, V., & Martin, D. C. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2018.10.013 · Cited by 427 · see citing works
Structural and molecular features of the endomyometrium in endometriosis and adenomyosis
Benagiano, G., Brosens, I., & Habiba, M. (2014) · Human Reproduction Update · doi:10.1093/humupd/dmt052 · Cited by 246 · see citing works
“Reference was made to animal studies for added clarity.”
BackgroundPathogenesis of deep endometriosis
Gordts, S., Koninckx, P., & Brosens, I. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.08.036 · Cited by 241 · see citing works
The role of the peritoneum in the pathogenesis of endometriosis
Young, V. J., Brown, J. K., Saunders, P. T. K., & Horne, A. W. (2013) · Human Reproduction Update · doi:10.1093/humupd/dmt024 · Cited by 177 · see citing works
Risks of adverse pregnancy outcome in endometriosis
Brosens, I., Brosens, J. J., Fusi, L., Al-Sabbagh, M., Kuroda, K., & Benagiano, G. (2012) · Fertility and Sterility · doi:10.1016/j.fertnstert.2012.02.024 · Cited by 132 · see citing works
Endometriosis-associated ovarian neoplasia
Matías‐Guiu, X., & Stewart, C. J. R. (2017) · Pathology · doi:10.1016/j.pathol.2017.10.006 · Cited by 131 · see citing works
The eutopic endometrium in endometriosis: are the changes of clinical significance?
Brosens, I. A., Brosens, J. J., & Benagiano, G. (2012) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2012.01.022 · Cited by 124 · see citing works
“This maternal–embryonic cross-talk involves local mediators within the uterine microenvironment and PROK1 has been implicated in the regulation of a host of implantation-related genes (Evans et al., 2009). Salker et al. (2010) analysed mid-secretory endometrial biopsies and demonstrated that recurrent pregnancy loss i…”
BackgroundChowdhury, I., Banerjee, S., Driss, A., Xu, W., Mehrabi, S., Nezhat, C., Sidell, N., Taylor, R. N., & Thompson, W. E. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.27360 · Cited by 95 · see citing works
The Silent Threat to Women’s Fertility: Uncovering the Devastating Effects of Oxidative Stress
Kaltsas, A., Zikopoulos, A., Moustakli, E., Zachariou, A., Tsirka, G., Tsiampali, C., Palapela, N., Sofikitis, N., & Dimitriadis, F. (2023) · Antioxidants · doi:10.3390/antiox12081490 · Cited by 101 · see citing works
“It is thought to arise from a combination of factors, potentially including inflammation, a weakened immune system, and genetic predisposition [69].”
BackgroundSun, H., Li, D., Yuan, M., Li, Q., Zhen, Q., Li, N., & Wang, G. (2018) · Molecular Human Reproduction · doi:10.1093/molehr/gay049 · Cited by 87 · see citing works
Neural involvement in endometriosis: Review of anatomic distribution and mechanisms
Siquara De Sousa, A. C., Capek, S., Amrami, K. K., & Spinner, R. J. (2015) · Clinical Anatomy · doi:10.1002/ca.22617 · Cited by 77 · see citing works
Metabolomics reveals perturbations in endometrium and serum of minimal and mild endometriosis
Dutta, M., Singh, B. K., Joshi, M. V., Das, D., Subramani, E., Maan, M., Jana, S. K., Sharma, U., Das, S., Dasgupta, S., et al. (2018) · Scientific Reports · doi:10.1038/s41598-018-23954-7 · Cited by 75 · see citing works
The Endometrium in Adenomyosis
Benagiano, G., & Brosens, I. A. (2012) · Women s Health · doi:10.2217/whe.12.8 · Cited by 73 · see citing works
Endometriosis, especially mild disease: a risk factor for miscarriages
Kohl Schwartz, A. S., Wölfler, M. M., Mitter, V., Rauchfuss, M., Haeberlin, F., Eberhard, M., von Orelli, S., Imthurn, B., Imesch, P., Fink, D., et al. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.08.025 · Cited by 63 · see citing works
“ART 353 itself does not pose a risk for miscarriages, but the underlying specific reproductive disorders 354 and the increased age, both affecting oocyte quality are of very high importance when 355 assessing miscarriage risk (69) in these women.”
BackgroundInfluentialAromatase inhibitors in the treatment of endometriosis
Słopień, R., & Męczekalski, B. (2016) · Menopause Review/Przegląd Menopauzalny · doi:10.5114/pm.2016.58773 · Cited by 56 · see citing works
“This is the underlying mechanism that triggers the virtuous cycle leading to the new growth of ectopic endometrial tissue [10].”
BackgroundAutophagy in endometriosis: Friend or foe?
Zhan, L., Li, J., & Wei, B. (2017) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2017.10.145 · Cited by 56 · see citing works
“Actually, as studies continued, it was acceptable that the patho genesis of endometriosis is polyfactorial which involved in reflux menstruation , hormonally mediated proliferation and apoptosis [8,9,10], hematologic s pread, inflammation, immune response and genetic factors [2].”
Naqvi, H., Sakr, S., Presti, T., Krikun, G., Komm, B., & Taylor, H. S. (2014) · Biology of Reproduction · doi:10.1095/biolreprod.113.114165 · Cited by 54 · see citing works
“While the etiology remains enigmatic, dependence on estrogens for growth and a modified response to estrogens and progesterone affecting the ectopic endometrium are essential to the development of endometriosis [3, 4].”
BackgroundSun, S., Guo, J. J., Qu, X., Tang, X., Lin, Y., Hua, K., & Qiu, J. (2021) · Human Reproduction · doi:10.1093/humrep/deab266 · Cited by 52 · see citing works
New adverse obstetrics outcomes associated with endometriosis: A retrospective cohort study
Mannini, L., Sorbi, F., Noci, I., Ghizzoni, V., Perelli, F., Di Tommaso, M., Mattei, A., & Fambrini, M. (2017) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-016-4222-7 · Cited by 47 · see citing works
Potential role of aromatase inhibitors in the treatment of endometriosis
Hashim, H. A. (2014) · International Journal of Women s Health · doi:10.2147/ijwh.s34684 · Cited by 46 · see citing works
“5,6 As endometriosis is an estrogen-dependent disease, conventional treatments utilized for many years aimed to act indirectly to create an estrogen-deficient state, eg, gonadotropin-releasing hormone agonists (GnRHas) and combined oral contraceptive pills or counteracting estrogen action, eg,…”
Oxidative Cell Injury as a Predictor of Endometriosis Progression
Carvalho, L. F. P., Abrão, M. S., Biscotti, C. V., Sharma, R. K., Nutter, B., & Falcone, T. (2013) · Reproductive Sciences · doi:10.1177/1933719112466301 · Cited by 43 · see citing works
“Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity; it remains one of the most important causes of pelvic pain and infertility in reproductive age.(1) It is considered as a benign gynecological condition; however, in some cases, it can significantly decrease quality of life being…”
BackgroundIs adenomyosis the neglected phenotype of an endomyometrial dysfunction syndrome?
Brosens, I. A., Kunz, G., & Benagiano, G. (2011) · Gynecological Surgery · doi:10.1007/s10397-011-0723-3 · Cited by 41 · see citing works
“During the last decade, many more molecules and functions have been found to be altered in endometriosis [16] and adenomyosis [17].”
BackgroundRocha, A. L. L., Carrarelli, P., Novembri, R., Pascalis, F. D., Luisi, S. V., dos Reis, F. M., & Petraglia, F. (2012) · Reproductive Sciences · doi:10.1177/1933719111434542 · Cited by 39 · see citing works
“There is cumulative and consistent evidence that the eutopic endometrium of women with endometriosis has intrinsic alterations, which may be critically involved in the pathogenesis of the disease.(14) Endometriosis is a benign sex hormone-dependent gynecological disease, characterized by the presence and growth of”
Backgroundde Sousa, A. C. S., Capek, S., Howe, B. M., Jentoft, M. E., Amrami, K. K., & Spinner, R. J. (2015) · Neurosurgical FOCUS · doi:10.3171/2015.6.focus15208 · Cited by 38 · see citing works
Emerging therapy for endometriosis
Lindsay, S. F., Luciano, D. E., & Luciano, A. A. (2015) · Expert Opinion on Emerging Drugs · doi:10.1517/14728214.2015.1051966 · Cited by 36 · see citing works
“apoptosis and promotion of proliferation of the transplanted eutopic endometrium [4].”
BackgroundGonadotrophin-releasing hormone analogues and endometriosis: current strategies and new insights
Hashim, H. A. (2012) · Gynecological Endocrinology · doi:10.3109/09513590.2011.650751 · Cited by 29 · see citing works
“decidualization capacity of the endometrium, (5) angiogenesis, (6) oxidative stress markers and (7) nerve cell studies [8].”
Research advances in drug therapy of endometriosis
Shi, J., Tan, X., Feng, G., Yuan, Z., Jiang, Z., Banda, S., Wang, L., Zheng, W., Chen, L., Yu, D., et al. (2023) · Frontiers in Pharmacology · doi:10.3389/fphar.2023.1199010 · Cited by 30 · see citing works
“This is a potential mechanism for triggering a vicious cycle leading to new growth of ectopic endometrial tissue (Carvalho et al., 2011).”
BackgroundSiva, A. B., Srivastava, P., & Shivaji, S. (2013) · PROTEOMICS - CLINICAL APPLICATIONS · doi:10.1002/prca.201200082 · Cited by 25 · see citing works
“These include a variety of differences in structure, proliferation, immune components, invasive properties, apoptosis, alterations in expression of specific genes and proteins, steroid, and cytokine production [2, 3, 17–19].”
BackgroundZhang, J., Li, H., Yi, D., Lai, C., Wang, H., Zou, W., & Cao, B. (2019) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-019-0512-9 · Cited by 24 · see citing works
Role of Versican in the Pathogenesis of Peritoneal Endometriosis
Tani, H., Sato, Y., Ueda, M., Miyazaki, Y., Suginami, K., Horie, A., Konishi, I., & Shinomura, T. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-2391 · Cited by 24 · see citing works
Carvalho, L. F. P., Rossener, R., Azeem, A., Malvezzi, H., Abrão, M. S., & Agarwal, A. K. (2013) · PubMed · Cited by 25 · see citing works
Is the Detection of Endometrial Nerve Fibers Useful in the Diagnosis of Endometriosis?
Leslie, C., Ma, T., McElhinney, B., Leake, R., & Stewart, C. J. R. (2013) · International Journal of Gynecological Pathology · doi:10.1097/pgp.0b013e31825b0585 · Cited by 23 · see citing works
“For example, an endometriosis-associated endometrium shows increased implantation capacity, induction of angiogenesis, and altered cell cycle regulation including differences in proliferation and apoptosis when compared with tissue from nonendometriotic subjects (19,20).”
BackgroundSyndecan-4 expression is upregulated in endometriosis and contributes to an invasive phenotype
Chelariu-Raicu, A., Wilke, C., Brand, M., Starzinski‐Powitz, A., Kiesel, L., Schüring, A. N., & Götte, M. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.03.032 · Cited by 21 · see citing works
Ultrastructural Features of Eutopic Endometrium in a Rat Model of Endometriosis
Elgamal, D. A., Othman, E. R., & Ahmed, S. (2015) · Journal of Microscopy and Ultrastructure · doi:10.1016/j.jmau.2015.10.002 · Cited by 20 · see citing works
Estrogen restricts the apoptosis of endometrial stromal cells by promoting TSLP secretion
Yang, H.-L., Chang, K.-K., Mei, J., Zhou, W.-J., Liu, L.-B., Yao, L., Meng, Y., Wang, M.-Y., Ha, S., Lai, Z.-Z., et al. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.9428 · Cited by 22 · see citing works
“…theory, intrinsic factors of the eutopic endometrium in women with EMS, including aberrantly produced cytokines, growth factors and specific cancer‑associated molecules, may be transported to the endometriotic implants and contribute to abnormal cell survival in ectopic tissues (14,18,19).”
McAllister, S. L., Giourgas, B. K., Faircloth, E. K., Leishman, E., Bradshaw, H. B., & Gross, E. R. (2016) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2016.08.017 · Cited by 20 · see citing works
“…of the eutopic uterus innervation is not clear, agreeably the biochemical, functional, and genetic differences of the cells of the eutopic endometrium in women with endometriosis are increasingly gaining recognition for their role in endometriosis-associated pain (Carvalho et al., 2011).”
BackgroundThe role of tissue factor and protease‐activated receptor 2 in endometriosis
Lin, M. T., Weng, H., Wang, X., Zhou, B., Yü, P., & Wang, Y. (2012) · American Journal of Reproductive Immunology · doi:10.1111/j.1600-0897.2012.01152.x · Cited by 19 · see citing works
Management of Chronic Pelvic Pain
Bishop, L. A. (2017) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000299 · Cited by 17 · see citing works
“It has been proposed that prostaglandins induce aromatase activity in the ectopic implants, leading to new growth.(24) A prospective study aimed at assessing the benefits of norethindrone acetate with and without the addition of letrozole showed greater improvement of pain in patients with the combination treatment.”
BackgroundMedical management of endometriosis
Newmark, A., Luciano, D. E., Ulrich, A., & Luciano, A. A. (2021) · Minerva Obstetrics and Gynecology · doi:10.23736/s2724-606x.21.04776-x · Cited by 16 · see citing works
The Extracellular Vesicle–Macrophage Regulatory Axis: A Novel Pathogenesis for Endometriosis
Gao, X., Gao, H., Shao, W., Wang, J., Li, M., & Liu, S. (2023) · Biomolecules · doi:10.3390/biom13091376 · Cited by 15 · see citing works
“Endometrial cells demonstrate greater resistance to apoptosis and the macrophages in the peritoneal fluid [95].”
BackgroundEnvironmental Pollution and Oxidative Stress: Health Effects During Pregnancy: A Review
Itziou, A., Balis, V., Lakioti, E., Karayannis, V., & Tsanaktsidis, C. G. (2024) · Applied Sciences · doi:10.3390/app14219884 · Cited by 17 · see citing works
“However, the body has developed some antioxidant defenses, mainly plasma uric and ascorbic acid, while α -tocopherol and ubiquinol appear to act as antioxidants by acting restrictively on lipid peroxidation [45].”
Mapping histological levels of 8-hydroxy-2′-deoxyguanosine in female reproductive organs
Carvalho, L. F. P., Abrão, M. S., Biscotti, C., Sharma, R. K., Agarwal, A. K., & Falcone, T. (2012) · Journal of Molecular Histology · doi:10.1007/s10735-012-9454-7 · Cited by 13 · see citing works
Classificação histológica e qualidade de vida em mulheres portadoras de endometriose
Porto, B. T. D. C., Ribeiro, H. S. A. A., Galvão, M. A. L., Sekula, V. G., Aldrigui, J. M., & Ribeiro, P. A. (2015) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1590/so100-720320140004650 · Cited by 13 · see citing works
“Aspectos sociais (D6) 17,9 (20,2) 45,8 (15,1) 40,0 (25,5) 55,6 (29,9) 38,0 (25,7) 57,6 (25,2) 31,3 (39,3) 45,8 (29,2)”
Bassi, M. A., Arias, V., Filho, N. D., Gueuvoghlanian‐Silva, B. Y., Abrão, M. S., & Podgaec, S. (2015) · Reproductive Sciences · doi:10.1177/1933719115574341 · Cited by 12 · see citing works
Poli‐Neto, O. B., Carlos, D., Favaretto, A. L., Silva, J. C. R. E., Meola, J., & Tiezzi, D. G. (2021) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2021.103307 · Cited by 13 · see citing works
Minimal and mild endometriosis negatively impact on pregnancy outcome
Carvalho, L. F. P., Below, A., Abrão, M. S., & Agarwal, A. (2012) · Revista da Associação Médica Brasileira · doi:10.1590/s0104-42302012000500020 · Cited by 12 · see citing works
Wang, X., Cai, W., Liang, T., Li, H., Gu, Y., Wei, X., Zhang, H., & Yang, X. (2024) · European Journal of Histochemistry · doi:10.4081/ejh.2024.4131 · Cited by 11 · see citing works
Expression of the TFDP1 gene in the endometrium of women with deep infiltrating endometriosis
Jibrim, R. L. M., de Carvalho, C. V., Invitti, A. L., & Schor, E. (2019) · Gynecological Endocrinology · doi:10.1080/09513590.2018.1540569 · Cited by 11 · see citing works
“Thus, the molecular evaluation of the endometrium in patients with endometriosis is an important line of investigation for understanding the pathophysiology of the disease [5].”
BackgroundC-reactive protein of serum and peritoneal fluid in endometriosis.
Kianpour, M., Nematbakhsh, M., & Ahmadi, S. M. (2012) · Europe PMC (PubMed Central) · Cited by 9 · see citing works
Minimal and mild endometriosis negatively impact on pregnancy outcome
Carvalho, L. F. P., Below, A., Abrão, M. S., & Agarwal, A. K. (2012) · Revista da Associação Médica Brasileira · doi:10.1016/s0104-4230(12)70257-9 · Cited by 9 · see citing works
Hu, Y., Xiang, Y., & Huang, W. (2023) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.15794 · Cited by 8 · see citing works
“10 – 12 Meta-analysis confirmed a significantly higher risk of endometrial polyps in women with endometriosis.”
BackgroundUterine myoma. Alternative methods of treatment
Dobrokhotova, Y. E., Ilyina, I. Y., Ибрагимова, Д. М., & Нариманова, М. Р. (2018) · Russian Journal of Human Reproduction · doi:10.17116/repro201824283-87 · Cited by 8 · see citing works
Михалева, Л. М., Андреевна, С. А., Ap, M., Beeraka, N. M., Николаевна, Х. Т., Chabieva, L. B., Александрович, М. С., Gracheva, N. A., Chigray, L. V., Beylerli, O., et al. (2021) · Reproductive Sciences · doi:10.1007/s43032-021-00508-3 · Cited by 8 · see citing works
Ye, X., Song, X., Zhou, S., Chen, G., & Wang, L. (2025) · Medicine · doi:10.1097/md.0000000000042816 · Cited by 7 · see citing works
“[1,19] This aligns with research indicating that dysfunctional eutopic endometrium is linked to reduced fertility in individuals with endometriosis, underscoring the crucial role of eutopic endometrium in the development of endometriosis.”
Medzhidova, A. M., & Эседова, А. Э. (2017) · Research and Practical Medicine Journal · doi:10.17709/2409-2231-2017-4-4-10 · Cited by 7 · see citing works
The pathogenesis of endometriosis: clues from the immunological evidence
Villanacci, R., Bandini, V., Ottolina, J., Pagliardini, L., Candiani, M., & Viganò, P. (2021) · Minerva Obstetrics and Gynecology · doi:10.23736/s2724-606x.21.04768-7 · Cited by 7 · see citing works
Shi, J., Qi, Y., Sun, Y., & Huang, Y. (2023) · American Journal Of Pathology · doi:10.1016/j.ajpath.2023.10.006 · Cited by 7 · see citing works
D-chiro-inositol effectively counteracts endometriosis in a mouse model
Placidi, M., Casoli, G., Vergara, T., Bianchi, A. S., Cocciolone, D., Zaccardi, S., Macchiarelli, G., Palmerini, M. G., Tatone, C., Bevilacqua, A., et al. (2025) · Molecular Medicine · doi:10.1186/s10020-025-01178-6 · Cited by 6 · see citing works
“These results are consistent with the hypothesis by Carvalho and colleagues regarding the use of aromatase inhibitors in the treatment of this disorder (Carvalho et al. 2011).”
Endometriosis and infertility: biomarkers affecting implantation rate
Carvalho, L. F. P., Hui, C. Y., & Agarwal, A. K. (2013) · Expert Review of Obstetrics & Gynecology · doi:10.1586/17474108.2013.825456 · Cited by 6 · see citing works
O'Malley, J., Iacovou, M., & Holdsworth‐Carson, S. J. (2021) · Frontiers in Reproductive Health · doi:10.3389/frph.2021.726598 · Cited by 6 · see citing works
“Although this explains extrauterine endometrial-like tissue, it does not give the full pathogenesis, as retrograde menstruation occurs in more than 80% of women (4).”
BackgroundReactive Oxygen Species and Female Infertility
Premkumar, B. J., Aponte, A., Shaman, A. A., & Agarwal, A. K. (2014) · Springer eBooks · doi:10.1007/978-3-642-30018-9_114 · Cited by 6 · see citing works
Minimal and mild endometriosis negatively impact on pregnancy outcome
Carvalho, L. F. P., Below, A., Abrão, M. S., & Agarwal, A. K. (2012) · Revista da Associação Médica Brasileira (English Edition) · doi:10.1016/s2255-4823(12)70257-6 · Cited by 5 · see citing works
Menstrual Effluent in the Pathogenesis and Diagnosis of Endometriosis—A Systematic Review
Watrowski, R., Kostov, S. G., Tsoneva, E., Schäfer, S. D., Sparić, R., Palumbo, M., Günther, V., Akšam, S. S., Yordanov, A. D., Chieppa, P., et al. (2026) · Diagnostics · doi:10.3390/diagnostics16050677 · Cited by 4 · see citing works
Seven ways to preserve female fertility in patients with endometriosis
Carvalho, L., Nataraj, N., Rao, J., Khetarpal, S., Abrão, M. S., & Agarwal, A. K. (2012) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.12.19 · Cited by 4 · see citing works
Poli‐Neto, O. B., Meola, J., & Silva, J. C. R. E. (2020) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1055/s-0040-1713807 · Cited by 4 · see citing works
Deraya, I. E., Hestiantoro, A., Muharam, R., Marwali, M. L. S., Asadi, A. S., Darmawi, D., Harzif, A. K., Pratama, G., Ocktariyana, O., Zahrah, A., et al. (2020) · Asia-Pacific Journal of Molecular Biology and Biotechnology · doi:10.35118/apjmbb.2020.028.2.05 · Cited by 4 · see citing works
“Endometrial of women with endometriosis featured to be abnormal in cellular and molecular mechanism compared to unaffected women (Carvalho et al., 2011).”
Tellez-Quijorna, C., Juan-Lopez, A., Eritja, N., Llobet‐Navàs, D., & Devis, L. (2025) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-025-01494-w · Cited by 3 · see citing works
Söhngen, L., Schmidt, M., Wimberger, P., Kimmig, R., & Grümmer, R. (2014) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2014.08.004 · Cited by 3 · see citing works
Predisposing and Protective Factors of Endometriosis
Gupta, S., Harlev, A., Agarwal, A. K., & Pandithurai, E. (2015) · SpringerBriefs in reproductive biology · doi:10.1007/978-3-319-18308-4_2 · Cited by 3 · see citing works
Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
Jacobo, A., Borges, R. F., de Souza, C. A. B., Genro, V. K., & Cunha‐Filho, J. S. (2024) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.61622/rbgo/2024rbgo31 · Cited by 2 · see citing works
The Endometrium in Adenomyosis
Habiba, M. A., & Benagiano, G. (2015) · Springer eBooks · doi:10.1007/978-3-319-13012-5_6 · Cited by 2 · see citing works
Asociación entre endometriosis pélvica y estrés oxidativo
Lázaro, J. P. M., Viola-Rhenals, M., & Monterrosa-Castro, Á. D. J. (2013) · Revista Colombiana de Obstetricia y Ginecología · doi:10.18597/rcog.121 · Cited by 1 · see citing works
IVF Treatment in Patients with Endometriosis: A Challenger Approach
Carvalho, L., & Missmer, S. A. (2012) · Journal of Fertilization In Vitro - IVF-Worldwide Reproductive Medicine Genetics & Stem Cell Biology · doi:10.4172/2165-7491.1000e108 · Cited by 1 · see citing works
“Endometriosis may affect fertility via: abnormal folliculogenesis; changes in ovarian steroid enzymes; impaired oocyte maturation leading to poor oocyte quality and consequently reduced fertilization rate or poor embryo quality; high levels of caustic peritoneal fluid components such as oxidative stress and inflammato…”
BackgroundFebriani, A., Sutrisno, S., Irwanto, Y., Baihaqi, I., Wıyasa, I. W. A., & Rahardjo, B. (2022) · Asian Journal of Health Research · doi:10.55561/ajhr.v1i3.35 · Cited by 1 · see citing works
Oskotsky, T., Tang, X., Arthurs, E., Govil, A., Abbasi, F., Bhoja, A., Bunis, D. G., Lau, A., Einhaus, J. F., Diop, M., et al. (2026) · iScience · doi:10.1016/j.isci.2026.117153 · Cited by 1 · see citing works
“59 Eutopic endometrium can offer important insights into disease mechanisms 60 and can serve as a practical foundation for therapeutic target discovery.”
Laparoscopic Excision of Endometriosis
Rossener, R., Carvalho, L. F. P., Salgado, J. L., & Abrão, M. S. (2014) · Springer eBooks · doi:10.1007/978-1-4614-6840-0_5 · Cited by 1 · see citing works
Endometriosis: causas, histopatogenia y epidemiología en México y el mundo
Luna, A. G., Ruiz, R. P., Álvarez, D. M., Rojas, R. M. L., & Vásquez, A. G. L. (2013) · Revista Mexicana de Medicina de la Reproducción · Cited by 1 · see citing works
Comparative analysis of eutopic endometrium from women with and without endometriosis
Adamyan, L. V., Aznaurova, Y. B., & Osipova, A. A. (2018) · Russian Journal of Human Reproduction · doi:10.17116/repro201824310 · Cited by 1 · see citing works
FACTORS OF ENDOMETRIAL RECEPTIVITY DOWN-REGULATION IN GENITAL ENDOMETRIOSIS
Marinkin, I. O., Aidagulova, S. V., Кулешов, В. М., & Timofeeva, Y. S. (2020) · Репродуктивная медицина · doi:10.37800/rm2020-1-13 · Cited by 1 · see citing works
Xiang, Y., Zhu, H., Long, Y., Huang, X., Ouyang, Y., & Huang, W. (2021) · Research Square · doi:10.21203/rs.3.rs-145883/v1 · Cited by 1 · see citing works
Adolescent Endometriosis: Review of Clinical Presentation and Long-Term Issues
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The role of the sympathetic nervous system and semaphorins in the pathogenesis of endometriosis
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Is Endometriosis a Surgical Disease?
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“The uterine endometrium is known to be abnormal in endometriosis, and retrograde menstruation of uterine endometrial glands/stroma through the fallopian tubes and into the pelvis is the major etiologic mechanism for the development of endometriosis [9-11].”
BackgroundTorky, H. A., El-Sabaa, K. G., & Soliman, S. M. (2017) · Journal of Gynecologic Surgery · doi:10.1089/gyn.2017.0007
“Burney and Giudice 4 and Carvalho et al. 5 provided another explanation for postmenopausal endometriosis, which is the presence of aromatase enzyme responsible for the peripheral conversion of androgens to estrogen in the endometriotic lesions unlike normal endometrium.”
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Risk factors for recurrence of endometrioid ovarian cysts after combined treatment
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Letrozole plus metformin versus letrozole alone in the treatment of symptomatic endometrioma
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Oxidative Stress Factors is Effective on Reproductive Functions: A Review
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Parasympathetic and Sympathetic Nervous System Dysfunction and Monitoring
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N-Acetylcysteine in Endometriosis: A Systematic Review of Biological Rationale and Clinical Evidence
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“The eutopic endometrium appears biologically altered before ectopic implantation, with enhanced proliferative, adhesive, angiogenic, and immune-evasive properties [19,20].”
- Authors
- Carvalho, L., Podgaec, S., Bellodi-Privato, M., Falcone, T., & Abrão, M. S.
- Affiliations
- Cleveland Clinic (US)
- Venue
- Journal of Minimally Invasive Gynecology
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 18
- Issue
- 4
- Pages
- 419-427
- ISSN
- 1553-4650 (ISSN-L)
- OpenAlex
- W2019599115
- Cited by
- 99
- References
- 97
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 3 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 7 · 2017: 7 · 2016: 6 · 2015: 8 · 2014: 7 · 2013: 10 · 2012: 14
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Minimally Invasive Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- pelvic endometriosis, eutopic endometrium, endometriosis pathogenesis, endometrial gene expression, progesterone response, oxidative stress, endometrial abnormalities
- MeSH terms
- Endometriosis, Endometrium, Female, Humans, Pelvis
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