There are lots of
articles being published on endometriosis all the time, (for example there were
over a thousand articles either directly or indirectly related to endometriosis
published last year) the main reason this blog exists is because the vast majority
of these studies never get read by people actually affected by the disease.
Mostly this is because these studies are published in scientific journals and/or
hidden behind online paywalls only accessible to people in academic
institutions, and even then the studies are written in very dry, scientific
terms.
Sometimes research in endometriosis makes it to the news, but often this
is conveyed by journalists who, as well meaning as they can be, often
misinterpret or exaggerate scientific information. I aim to write about the
latest endometriosis research in a way anyone can read and understand, but
there is so much being published all the time it difficult to cover it all
here. Fortunately some research is made available for free for anyone to read,
so I’m starting a series providing free articles on a certain theme each time.
This time I’m going to be listing some of the most relevant, free articles
concerning one of the major facets of endometriosis; fertility, how it affects
women, how surgery affects pregnancy rate, how fertility therapy can help women
with endometriosis and several other areas. Just click on the title of each
article to be taken to the full text.
As mentioned though
some of the articles are written in a rather dry prose and include a lot of
detail about scientific methods and analysis that may not be relevant to the
lay reader, so I would say the most important parts of some articles are the
introductions/background and the discussion/conclusions, so feel free to skip
to those parts to get the most interesting information. I’ve included the
summary for each article so you can see which ones are of most interest to you.
Authors: González-Comadran M, Schwarze JE, Zegers-Hochschild
F, Souza MD, Carreras R, Checa MÁ.
Published In: Reproductive Biology and Endocrinology. 2017
Jan 24;15(1):8. doi: 10.1186/s12958-016-0217-2.
Summary: Reproductive outcomes among women undergoing IVF and diagnosed
with endometriosis-associated infertility do not differ significantly from
women without the disease. Although women with endometriosis generate
fewer oocytes, fertilization rate is not impaired and the likelihood of
achieving a live birth is also not affected.
Authors: Nezhat
C, Li A, Abed S, Balassiano E, Soliemannjad R, Nezhat A, Nezhat CH, Nezhat F.
Published In:
Journal of the Society of Laproendoscopic Surgeons. 2016 Jul-Sep;20(3). pii:
e2016.00053. doi: 10.4293/JSLS.2016.00053
Summary: In our patient population, 87.1% of
patients with a chief concern of symptomatic fibroids also had a diagnosis of
histology-proven endometriosis, which affirms the need for concomitant
diagnosis and intraoperative treatment of both conditions. Overlooking the
coexistence of endometriosis in women with symptomatic leiomyoma may lead to
suboptimal treatment of fertility and persistent pelvic pain. It is important
for physicians to be aware of the possibility of this association and to
thoroughly evaluate the abdomen and pelvis for endometriosis at the time of
myomectomy or hysterectomy in an effort to avoid the need for reoperation.
Authors: Ke X,
Qian H, Kang L, Wang J, Xie Y, Cheng Z.
Published In: International
Journal of Clinical and Experimental Medicine. 2015 Nov 15;8(11):21703-6.
eCollection 2015
Summary: Surgery
can improve the symptom remission rate and fertility of patients.
Postoperative drug therapy does not improve the chance of pregnancy
Authors:
Nesbitt-Hawes EM, Campbell N, Maley PE, Won H, Hooshmand D, Henry A, Ledger W,
Abbott JA.
Published In:
Biomed Research International. 2015;2015:438790. doi: 10.1155/2015/438790. Epub
2015 Jul 12.
Summary: These
data provide information to women with suspected severe disease preoperatively
concerning their likely postoperative fertility outcomes. Ours is a
population with severe endometriosis, rather than an infertile population
with endometriosis, so caution needs to be applied when applying these
data to women with fertility issues alone.
Authors: Xu
B, Guo N, Zhang XM, Shi W, Tong XH, Iqbal F, Liu YS.
Published In:
Scientific Reports. 2015 May 29;5:10779. doi: 10.1038/srep10779
Summary: Endometriosis,
a pathological condition in which the endometrium grows outside the uterus, is
one of the most common causes of female infertility; it is diagnosed in 25-40%
of infertile women. The mechanism by which endometriosis affects the fertility of
females remains largely unknown. We examined the ultrastructure of oocytes from
patients with minimal or mild endometriosis and control females
undergoing in vitro fertilization (IVF) treatment. Our results suggest that
decreased oocyte quality because of impaired mitochondrial structure and
functions probably an important factor affecting
the fertility of endometriosis patients.
Authors: Mavrelos
D, Saridogan E.
Published In:
Journal of Obstetrics and Gynaecology of India. 2015 Feb;65(1):11-6. doi:
10.1007/s13224-014-0652-y.
Summary: Endometriosis
is a common condition affecting a significant proportion of women in their
reproductive age. Apart from the impact of endometriosis on the quality of life
of these patients, it also can have an impact on the potential of these women
to have a family. The options for treating women with endometriosis desiring a
family include surgery or assisted reproduction techniques. The choice of
treatment will depend on the stage of disease and the characteristics of the
couple seeking help. We review here the latest evidence on the management of
endometriosis in women desiring fertility and describe our current practice.
Authors:
Borghese B, Sibiude J, Santulli P, Lafay Pillet MC, Marcellin L, Brosens I,
Chapron C.
Published In:
PLoS One. 2015 Feb 13;10(2):e0117387. doi: 10.1371/journal.pone.0117387.
Summary: The
influence of intrauterine environment on the risk of endometriosis is
still controversial. Whether birth weight modifies the risk of endometriosis in
adulthood remains an open question. For this purpose, we designed a
case-control study involving 743 women operated on for benign gynecological
indications from January 2004 to December 2011. Among patients with LBW, the
risk is almost two-times higher to develop DIE. This association could reflect
common signalling pathways between endometriosis and fetal growth
regulation. There is also the possibility of a role played by placental
insufficiency on the development of the neonate's pelvis and the occurrence of
neonatal uterine bleeding that could have consequences on the risk of severe endometriosis.
Authors:
Fadhlaoui A, Bouquet de la Jolinière J, Feki A.
Published In:
Frontiers of Surgery. 2014 Jul 2;1:24. doi: 10.3389/fsurg.2014.00024.
Summary: Endometriosis is
defined as the presence of endometrial-like tissue (glands or stroma) outside
the uterus, which induces a chronic inflammatory reaction.
Although endometriosis impairs fertility, it does not usually
completely prevent conception. The question of evidence based-medicine
guidelines in endometriosis-associated infertility is weak in many
situations. Therefore, we will highlight in this issue where the challenges
are.
(endometriosis
covered in chapter 10)
Authors: Various
Summary: This
guideline offers best practice advice on assisting people of reproductive age
who have problems conceiving. It is estimated that infertility affects about
one in seven heterosexual couples in the UK. Since the original NICE guideline
on fertility was published in 2004 there has been a small increase in
the prevalence of fertility problems and a greater proportion of
people now seeking help for such problems. The main causes of infertility in
the UK are (percentage figures indicate approximate prevalence): ovulatory
disorders (25%); tubal damage (20%); factors in the male causing infertility
(30%); uterine or peritoneal disorders (10%). In about 25% of cases infertility
is unexplained, with no identified male or female cause. In about 40% of cases
disorders are found in both the man and the woman. Uterine or endometrial
factors, gamete or embryo defects, and pelvic conditions such
as endometriosis may also play a role. Given the range of causes
of fertility problems, the provision of appropriate investigations is
critical. These investigations include semen analysis; assessment of ovulation,
tubal damage and uterine abnormalities; and screening for infections such
as Chlamydia trachomatis and susceptibility to rubella. Once a
diagnosis has been established, treatment falls into three main types: medical
treatment to restore fertility (for example the use of drugs for
ovulation induction); surgical treatment to restore fertility (for
example laparoscopy for ablation of endometriosis); assisted reproduction
technology (ART) – any treatment that deals with means of conception other than
vaginal coitus; frequently involving the handling of gametes or embryos.
Authors: Jin X,
Ruiz Beguerie J.
Published in: Taiwan
Journal of Obstetrics and Gynecology. 2014 Sep;53(3):303-8. doi:
10.1016/j.tjog.2013.02.004.
Summary: The use of laparoscopic surgery in the
treatment of subfertility related to minimal endometriosis may
increase the chances of future pregnancy and live birth
Authors: Dong X,
Liao X, Wang R, Zhang H.
Published in: International
Journal of Clinical and Experimental Pathology. 2013 Aug 15;6(9):1911-8.
Summary: Except reduced implantation rate in stage
III-IV endometriosis group, no differences were found in other
pregnancy parameters. This study suggests that IVF/ICSI yielded similar
pregnancy outcomes in patients with different stages ofendometriosis and
patients with tubal infertility. Therefore, IVF/ICSI can be considered as an
effective approach for managingendometriosis-associated infertility.
Authors: Macer
ML, Taylor HS.
Published in: Obstet
Gynecol Clin North Am. 2012 Dec;39(4):535-49. doi:10.1016/j.ogc.2012.10.002.
Summary: Endometriosis
has been associated with infertility; however, the mechanisms by which it
affects fertility are still not fully understood. This article
reviews the proposed mechanisms of endometriosis pathogenesis, its
effects on fertility, and treatments of endometriosis-associated
infertility. Theories on the cause of the disease include retrograde
menstruation, coelomic metaplasia, altered immunity, stem cells, and
genetics. Endometriosis affects gametes and embryos, the fallopian
tubes and embryo transport, and the eutopic endometrium; these abnormalities
likely all impact fertility. Current treatment options
of endometriosis-associated infertility include surgery, superovulation
with intrauterine insemination, and in vitro fertilization. We also discuss potential
future treatments for endometriosis-related infertility.
Authors: Carvalho
LF, Below A, Abrão MS, Agarwal A.
Published in: Revista
de Associacao Medica Brasileira (1992). 2012 Sep-Oct;58(5):607-14.
Summary: Endometriosis,
a highly prevalent gynecological disease, can lead to infertility in moderate
to severe cases. Whether minimal stages are associated with infertility is
still unclear. The purpose of this systematic review is to present studies
regarding the association between pregnancy rates and the presence of early
stages of endometriosis.
Authors: Lerchbaum
E, Obermayer-Pietsch B.
Published In: European
Journal of Endocrinology. 2012 May;166(5):765-78. doi: 10.1530/EJE-11-0984.
Summary: Vitamin D has been well-known for its
function in maintaining calcium and phosphorus homeostasis and promoting bone
mineralization. There is some evidence that in addition to sex steroid
hormones, the classic regulators of human reproduction, vitamin D also
modulates reproductive processes in women and men
Authors: Bulletti
C, Coccia ME, Battistoni S, Borini A.
Published in: Journal
of Assisted Reproduction and Genetics. 2010 Aug;27(8):441-7. doi:
10.1007/s10815-010-9436-1.
Summary: Endometriosis is
a debilitating condition characterized by high recurrence rates. The aetiology
and pathogenesis remain unclear. Typically, endometriosis causes pain
and infertility, although 20-25% of patients are asymptomatic. The principal
aims of therapy include relief of symptoms, resolution of existing
endometriotic implants, and prevention of new foci of ectopic endometrial
tissue. Current therapeutic approaches are far from being curative; they focus
on managing the clinical symptoms of the disease rather than fighting the
disease. Specific combinations of medical, surgical, and psychological
treatments can ameliorate the quality of life of women with endometriosis.
The benefits of these treatments have not been entirely demonstrated,
particularly in terms of expectations that women hold for their own lives.
Although theoretically advantageous, there is no evidence that a combination
medical-surgical treatment significantly enhances fertility, and it may
unnecessarily delay further fertility therapy. Randomized controlled
trials are required to demonstrate the efficacy of different treatments.
Access to articles is
provided by US National Library of Medicine and National Institutes of Health
as well as individual publishers
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