Cited by 154Endometriosis Research and TreatmentEctopic Pregnancy Diagnosis and ManagementGynecological conditions and treatments

The DOI matches its Crossref record; 128 of the 130 references it cites were found in a registry or an index; 12 of the 158 sources its claims cite were checked for support.

Defining Future Directions for Endometriosis Research: Workshop Report From the 2011 World Congress of Endometriosis in Montpellier, France

Open access

Abstract

Endometriosis, defined as estrogen-dependent lesions containing endometrial glands and stroma outside the uterus, is a chronic and often painful gynecological condition that affects 6% to 10% of reproductive age women. Endometriosis has estimated annual costs of US $12 419 per woman (approximately €9579), comprising one-third of the direct health care costs with two-thirds attributed to loss of productivity. Decreased quality of life is the most important predictor of direct health care and total costs. It has been estimated that there is a mean delay of 6.7 years between onset of symptoms and a surgical diagnosis of endometriosis, and each affected woman loses on average 10.8 hours of work weekly, mainly owing to reduced effectiveness while working. To encourage and facilitate research into this debilitating disease, a consensus workshop to define future directions for endometriosis research was held as part of the 11th World Congress on Endometriosis in September 2011 in Montpellier, France. The objective of this workshop was to review and update the endometriosis research priorities consensus statement developed following the 10th World Congress on Endometriosis in 2008.(1) A total of 56 recommendations for research have been developed, grouped under 6 subheadings: (1) diagnosis, (2) classification and prognosis, (3) clinical trials, treatment, and outcomes, (4) epidemiology, (5) pathophysiology, and (6) research policy. By producing this consensus international research priorities statement, it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This workshop report updates the 2008 consensus research priorities for endometriosis from the 2011 World Congress, producing 56 recommendations across six domains. It summarizes background burden data and expert recommendations for diagnosis, classification, clinical trials, epidemiology, pathophysiology, and research policy.

Key findings

  • Endometriosis affects an estimated 6% to 10% of reproductive-age women; annual costs are estimated at US $12,419 per woman (approximately €9,579), comprising one-third direct health care costs and two-thirds productivity loss, with a mean 6.7-year delay between symptom onset and surgical diagnosis and an average 10.8 hours of work lost weekly.
  • Between the 2008 and 2011 World Congress meetings, 3,176 new endometriosis publications were recorded on PubMed, a 21.5% increase over the total number published prior to 2008; major contributions included the first two genome-wide association studies and ongoing nerve fiber work.
  • The workshop developed 56 research recommendations grouped under 6 subheadings: diagnosis; classification and prognosis; clinical trials, treatment, and outcomes; epidemiology; pathophysiology; and research policy.
  • Recommendations emphasize noninvasive biomarkers, imaging advances, better classification/prognostic tools, adequately powered multicenter randomized controlled trials with quality-of-life and live-birth outcomes, pain mechanisms, genetic/environmental/diet/BMI research, inflammation/oxidative stress/neuroangiogenesis/stem cells/apoptosis/miRNAs, and biobanks/registries/multidisciplinary approaches.

Methods

  • Consensus workshop held at the 11th World Congress on Endometriosis in September 2011 in Montpellier, France, convened by the World Endometriosis Society and World Endometriosis Research Foundation to review and update the 2008 consensus statement.
  • 58 participants from 19 countries attended; the meeting used 6 moderated sessions, with each moderator reviewing progress, discussing whether 2008 recommendations needed updating, leading discussion, and producing a written summary incorporated into the final report.
  • Narrative synthesis of expert discussion and literature; no primary data collection or systematic review methods are described.

Limitations

  • Stated limitations: Not stated in the paper.
  • Evident from text: this is a consensus workshop report; the recommendations are described as “by no means proscriptive” and are based on expert discussion rather than primary empirical testing.
  • Evident from text: many recommendations call for larger, well-designed, adequately powered studies and validation, indicating evidence gaps and limitations in the existing literature.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/1933719113477495

Cites

128 of 128 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

123 Not checked yet · 12 No basis given · 5 Supported · 4 Own result · 2 Supported so far · 2 Own interpretation · 1 Partly supported · accuracy not yet measured

Verify all 146 references — free account

Show all 92 claims

  • It may state two separate claims as one. 39
  • Probably not a substantial claim. 21
57 of 57
  • The paper relies on this without support.

    Peritoneal oxidative stress is one of the major constituents of the endometriosis-associated inflammatory response.

    “Peritoneal oxidative stress is thought to be one of the major constituent of the endometriosis-associated inflammatory response.”
  • The paper relies on this without support.

    Excessive production of ROS, secondary to peritoneal influx of prooxidants such as heme and iron, may induce cellular damage and increased proinflammatory gene expression through NF-kB activation.

    “Excessive production of reactive oxygen species (ROS), secondary to peritoneal influx of prooxidants such as heme and iron, may induce cellular damage and increased proinflammatory gene expression through NF-kB activation.”
  • The paper relies on this without support.

    ROS are proinflammatory mediators that modulate cell proliferation.

    “The ROS are proinflammatory mediators that modulate cell proliferation.”
  • The paper relies on this without support.

    The presence of unmyelinated sensory nerve fibers in the functional layer of endometrium and increased nerve fiber density in endometrium and myometrium in women with endometriosis suggests a possible role in pain perception.

    “The presence of unmyelinated sensory nerve fibers in the functional layer of endometrium and a significantly increased nerve fiber density in endometrium and myometrium in women with endometriosis suggests a possible role in pain perception.”
  • The paper relies on this without support.

    Angiogenesis and lymphangiogenesis are critical processes in the pathogenesis of endometriosis.

    “Angiogenesis and lymphangiogenesis, or the development of new blood and lymphatic vessels from preexisting ones, are critical processes in the pathogenesis of endometriosis.”
  • The paper relies on this without support.

    Clinical evidence for the efficacy of antiangiogenic endometriosis therapy is still lacking.

    “However, clinical evidence for their efficacy in antiangiogenic endometriosis therapy is still lacking.”
  • The paper relies on this without support.

    Progenitor stem cells have the capacity to generate endometriosis if shed in a retrograde fashion.

    “It is also likely that these same progenitor stem cells have the capacity to generate endometriosis if shed in a retrograde fashion.”
  • The paper relies on this without support.

    Stem cells not of uterine origin may migrate to and cause or contribute to endometriotic lesions.

    “It is also possible that stem cells that are not of uterine origin may migrate to and cause or contribute to endometriotic lesions, both in the peritoneal cavity and in the rarer instances where endometriosis occurs outside of the peritoneal cavity.”
  • The paper relies on this without support.

    Progestins have overall anti-inflammatory activity.

    “Progestins have overall anti-inflammatory activity, and there appears to be progesterone resistance in endometriotic lesions and eutopic endometrium of women with endometriosis.”
  • The paper relies on this without support.

    There is progesterone resistance in endometriotic lesions and eutopic endometrium of women with endometriosis.

    “Progestins have overall anti-inflammatory activity, and there appears to be progesterone resistance in endometriotic lesions and eutopic endometrium of women with endometriosis.”
  • The paper relies on this without support.

    Different progestins have different glucocorticoid and androgenic activity.

    “Given that different progestins have different glucocorticoid and androgenic activity there may be opportunities for modifying treatments to improve outcomes.”
  • The paper relies on this without support.

    Selective progesterone receptor modulators (SPRMs) may have a role in treating endometriosis.

    “Selective progesterone receptor modulators (SPRMs) may also have a role in treating endometriosis, although evidence to support this is lacking to date.”
  • The paper relies on this without support.

    Expression of VEGF-C and VEGF-D and their receptors neuropilin 2 is dysregulated in the endometrium from women with endometriosis.

    “It has recently been demonstrated that expression of the potent lymphangiogenic growth factors VEGF-C and VEGF-D and their receptors neuropilin 2 is dysregulated in the endometrium from women with endometriosis.”
  • The paper relies on this without support.

    Endometriosis organizations, often led by women with endometriosis, have greater credibility with politicians and the general public than scientists or physicians, giving them greater access to media and better effectiveness for educational campaigns.

    “Endometriosis Organizations, which are often led by women with endometriosis, have the ability to raise public awareness about the challenges posed by endometriosis more effectively than scientists or physicians, not the least because they are seen by politicians and the general public to have greater credibility.This gives greater access to media and better effectiveness for educational campaigns”
  • The paper relies on this without support.

    Different endometriosis organizations have been responsible for multimillion dollar outreach campaigns, public service announcement campaigns, numerous outreach mailings, e-mail blitzes, educational outreach videos, books, and brochures.

    “Different endometriosis organizations have been responsible for multimillion dollar outreach campaigns, public service announcement campaigns, numerous outreach mailings, and e-mail blitzes to key stakeholders, educational outreach videos, books, and brochures”
  • The paper relies on this without support.

    These activities have contributed significantly to raising the profile of endometriosis as a disease.

    “This has contributed significantly to raising the profile of endometriosis as a disease”
  • The paper relies on this without support.

    Women with endometriosis often have more persuasive power with government bodies, politicians, and institutions than others.

    “Women with endometriosis often have more persuasive power with government bodies, politicians, and institutions”
  • The paper relies on this without support.

    Personal stories and sharing experience and impact of a disease are more powerful than simply asking for research funds.

    “Personal stories and sharing experience and impact of a disease are more powerful than simply asking for research funds, and women with endometriosis have more political capital as they can represent a significant block of votes”
  • The paper relies on this without support.

    Women with endometriosis have more political capital because they can represent a significant block of votes.

    “Personal stories and sharing experience and impact of a disease are more powerful than simply asking for research funds, and women with endometriosis have more political capital as they can represent a significant block of votes”
19 of 19

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Citations

Cites

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Research works printed but not linked: 1

  1. Cakmak H, Guzeloglu-Kayisli O, Kayisli UA, Arici A. Immuneendocrine interactions in endometriosis. Front Biosci (Elite Ed). 2009;1(2):429–443.

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Metadata

Authors
Rogers, P. A. W., D’Hooghe, T. M., Fazleabas, A., Giudice, L. C., Montgomery, G. W., Petraglia, F., & Taylor, R. N.
Affiliations
  • Royal Women's Hospital (AU)
  • Universitair Ziekenhuis Leuven (BE)
  • Michigan State University (US)
  • University of California, San Francisco (US)
  • QIMR Berghofer Medical Research Institute (AU)
  • University of Siena (IT)
  • Wake Forest University Health Sciences (US)
Corresponding author
Rogers, Peter A. W.
Venue
Reproductive Sciences
Published
2013-05
Volume
20
Issue
5
Pages
483-499
ISSN
  • 1933-7191 (ISSN-L)
  • 1933-7205
OpenAlex
W2103672022
Cited by
154
References
130
Citations by year
2026: 1 · 2025: 6 · 2024: 2 · 2023: 9 · 2022: 7 · 2021: 16 · 2020: 15 · 2019: 6 · 2018: 5 · 2017: 16 · 2016: 23 · 2015: 19 · 2014: 28 · 2013: 1
FWCI
28.67
Type
journal article
Language
en
Open access
Locations
  • Reproductive Sciences (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • Use Siena air (University of Siena) (submittedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54HD055764, U54HD040093, 1U54HD40093, 1U54HD05576, U54HD055787)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Ectopic Pregnancy Diagnosis and Management
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Keywords
endometriosis, research priorities, consensus statement, endometriosis diagnosis, endometriosis classification, prognosis, clinical trials, treatment outcomes, pathophysiology, science policy, quality of life, economic burden, delayed diagnosis
MeSH terms
Animals, Endometriosis, Female, Forecasting, Humans, Prognosis, Consensus, Biomedical Research

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