Diet and endometriosis risk: a literature review.

A connection between dietary factors and endometriosis onset has become a topic of interest mostly due to the observation that physiological and pathological processes of the disease can be influenced by diet. This paper systematically reviews prior publications dealing with this aspect in order to identify potentially modifiable risk factors. Comprehensive searches in the electronic databases MEDLINE, EMBASE and Science Citation Index Expanded were conducted to identify published studies evaluating the association between food intake (nutrients and food groups) and endometriosis.

HLA-G expressing DC-10 and CD4(+) T cells accumulate in human decidua during pregnancy.

Multiple mechanisms underlie the surprising willingness of mothers to tolerate the semi-allogeneic fetal tissues during pregnancy. Chief among these is the expression of the HLA-G molecules that has been largely demonstrated to be responsible for reprogramming the local maternal immune response towards tolerance. We recently identified a subset of tolerogenic dendritic cells, DC-10 that secrete high amounts of IL-10 and express high levels of HLA-G and its ligand ILT4.

Exposure of embryos to oxygen at low concentration in a cleavage stage transfer program: reproductive outcomes in a time-series analysis.

Background: Embryos are exposed to oxygen at a concentration of 2% to 8% under in vivo conditions. Laboratory culture of embryos with oxygen at atmospheric tension impairs embryo metabolism and blastocyst development in several species. Indeed, a high rate of live births after a day 5 transfer has been obtained by lowering oxygen concentration in the incubator atmosphere, thus definitively proving the damaging effect of oxygen at atmospheric tension on late stage development of human embryos.

An Italian association study and meta-analysis with previous GWAS confirm WNT4, CDKN2BAS and FN1 as the first identified susceptibility loci for endometriosis.

Background: Although endometriosis may benefit from primary prevention measures, the epidemiological risk factors identified are equivocal. Two genome-wide association studies (GWAS) have been conducted for endometriosis in two different ethnic populations but results are still to be replicated consistently and across various ethnicities. To confirm the association of GWAS-derived susceptibility loci, we conducted a replication Italian case-control study and a meta-analysis.

Attractiveness of women with rectovaginal endometriosis: a case-control study.

Objective: To evaluate physical attractiveness in women with and without endometriosis.

Design: Case-control study.

Setting: Academic hospital.

Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications.

Objective: To evaluate serum antimüllerian hormone (AMH) level modification after surgical excision of ovarian endometriomas.

Design: Systematic review. MEDLINE search from January 1990 to April 2012 using the combination of medical terms endometriosis, endometrioma, endometriotic cyst, and AMH or antimüllerian hormone, MIF or müllerian inhibiting factor.

Unraveling the two entities of endometrioid ovarian cancer: a single center clinical experience.

Objective: Due to the increasing prevalence of the benign condition, ovarian carcinoma arising from endometriosis is emerging as a relevant clinical entity with an unclear biological signature. We have investigated clinical and histologic features of endometriosis-associated endometrioid ovarian cancer using an institutional retrospective database.

Methods: Patients diagnosed with endometrioid ovarian cancer at our institution were divided into two groups according to the fulfillment or not of Sampson's and Scott's criteria for the detection of endometriosis-associated ovarian cancer.

The selective vitamin D receptor agonist, elocalcitol, reduces endometriosis development in a mouse model by inhibiting peritoneal inflammation.

Background: Endometriosis, which is characterized by the growth of endometrial tissue at ectopic locations as well as vascular development and inflammation, is still an unmet clinical need since an optimal drug that allows for both pain and infertility management does not exist. Since both the eutopic and the ectopic endometrium express the vitamin D receptor (VDR), and VDR agonists are endowed with anti-proliferative and anti-inflammatory properties, we evaluated the effect of elocalcitol, a VDR agonist with low calcaemic liability, in a mouse model of experimentally induced endometriosis.

Methods And Results: Endometriosis was induced by injection of syngeneic endometrial tissue fragments into adult Balb/c female mice.

Adhesion prevention in endometriosis: a neglected critical challenge.

Prevention of adhesions, whether de novo or by re-formation, is one of the most important and surprisingly neglected aspect of the treatment of endometriosis. Adhesions may cause infertility, dyspareunia, chronic pelvic pain but also intestinal obstruction and complications at subsequent surgery. They may play a role in the development of some forms of the disease such as ovarian endometriomas and possibly also deep invasive nodules.

Endometriosis in a rural remote setting: a cross-sectional study.

Women in Western nations are exposed to an "unnatural" high number of menstrual cycles and this has been claimed to favour the development of endometriosis. If so, the prevalence of the disease should be low in remote rural settings characterized by high fertility rate, frequent teen-age pregnancy and protracted breast-feeding. To verify this hypothesis, we investigated the prevalence of endometriosis among women referring to the District Hospital of Aber, Northern Uganda for gynecological complaints.

The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres.

Background: This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres.

Methods: A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008.

Diagnostic value of serum activin A and follistatin levels in women with peritoneal, ovarian and deep infiltrating endometriosis.

Background: Activin A is a growth factor, produced by the endometrium, whose actions are modulated by the binding protein follistatin. Both proteins are detectable in the peripheral serum and their concentrations may be increased in women with endometriosis. The present study was designed to evaluate whether serum levels of activin A and follistatin are altered, and therefore have a potential diagnostic value, in women with peritoneal, ovarian and deep infiltrating endometriosis.

"You are so beautiful"*: behind women's attractiveness towards the biology of reproduction: a narrative review.

Female beauty has always attracted human beings. In particular, beauty has been interpreted in terms of reproductive potential and advantage in selection of mates. We have reviewed the recent literature on female facial and physical beauty with the objective of defining which parameters could influence female attractiveness.

Interferon-inducible genes, TNF-related apoptosis-inducing ligand (TRAIL) and interferon inducible protein 27 (IFI27) are negatively regulated in leiomyomas: implications for a role of the interferon pathway in leiomyoma development.

Uterine leiomyomas are the most common tumors in the human female pelvis and the leading indication for pelvic surgery. Lack of understanding of the molecular pathogenesis of leiomyoma has put severe limitations on the availability of alternative treatments. Using an oligonucleotide micro-array-based hybridisation analysis we observed a group of genes with a broad range of functional activity differentially expressed in smooth muscle cells (SMC) derived from leiomyomas when compared to matched myometrial cells.

Continuous low-dose oral contraceptive in the treatment of colorectal endometriosis evaluated by rectal endoscopic ultrasonography.

Objective: Limited attention has been focused on the medical treatment of bowel endometriosis. This study evaluates the efficacy of administration of a continuous low-dose oral contraceptive in treating pain and other symptoms associated with colorectal endometriotic nodules, as evaluated by rectal endoscopic ultrasonography.

Design: Prospective observational study.

Type I collagen and matrix metalloproteinase 1, 3 and 9 gene polymorphisms in the predisposition to pelvic organ prolapse.

Aim: To evaluate whether the presence of specific polymorphism in the gene promoter of collagen and some matrix metalloproteinases was associated with the risk of developing pelvic organ prolapse.

Methods: A case-control study was carried on 233 women: 137 were cases with ≥ stage II pelvic organ prolapse and 96 were matched controls without pelvic pathologies. Allele and genotype frequencies related to polymorphisms at the Sp1 site of type I collagen and some functional polymorphisms in the promoters of metalloproteinases-1, -3 and -9 have been compared between groups.

High rate of endometriosis recurrence in young women.

Objective: To evaluate rate and determinants of long-term recurrence of endometriosis in a population of young women.

Design: Retrospective cohort study.

Setting: University tertiary care referral center for women with benign gynecologic diseases.

Gene expression profiling of peripheral blood mononuclear cells in endometriosis identifies genes altered in non-gynaecologic chronic inflammatory diseases.

Background: Pelvic inflammatory phenomena have been suggested as critical players in the natural history of endometriosis. However, to what extent these events could affect the systemic immunologic status remains to be clarified. Here, we compared the gene expression profile in peripheral blood mononuclear cells from endometriosis patients in the severe diseased stage with the profile after a conventional surgical treatment for removal of endometriotic lesions and adhesions.

The 'incessant menstruation' hypothesis: a mechanistic ovarian cancer model with implications for prevention.

Serous, endometrioid, clear cell and mucinous histotypes are the most common epithelial ovarian cancer. Most serous cancers appear to originate from precursor lesions at the fimbriated tubal end, whereas most endometrioid and clear cell cancers seem to derive from atypical endometriosis. Data regarding hormonal factors and associated gynaecologic conditions were critically analysed with the objective of defining a carcinogenic model for sporadic epithelial ovarian cancer complying with epidemiologic and pathologic findings.

Perinatal environment and endometriosis.

Background/aims: Perinatal environmental exposure may affect fetal development and reprogram the developing organism for adult-onset disease. In this case-control study, we aimed at assessing this pathogenetic model in endometriosis.

Methods: Consecutive patients with a first laparoscopic diagnosis of endometriosis were selected as cases.

Deep pelvic endometriosis negatively affects ovarian reserve and the number of oocytes retrieved for in vitro fertilization.

Objective: Endometriosis-associated infertility results in reduced ovarian response, fewer oocytes available for fertilization, compromised oocyte quality and higher miscarriage rates. A consistent proportion of women with endometriosis require in vitro fertilization. We sought to clarify the impact of deep infiltrating pelvic disease on antral follicle count and ovarian response to follicle-stimulating hormone (FSH) stimulation in patients with severe endometriosis.

'Waiting for Godot': a commonsense approach to the medical treatment of endometriosis.

Conservative surgical treatment for symptomatic endometriosis is frequently associated with only partial relief of pelvic pain or its recurrence. Therefore, medical therapy constitutes an important alternative or complement to surgery. However, no available compound is cytoreductive, and suppression instead of elimination of implants is the only realistic objective of pharmacological intervention.

Priorities for endometriosis research: a proposed focus on deep dyspareunia.

Women with endometriosis have a substantial increase in risk of deep dyspareunia with respect to the general female population of corresponding age. This symptom has personal and intimate implications, including unfavorable emotional impact in partners. Deep dyspareunia caused by endometriosis can be viewed as an originally visceral type of pain secondary to chronic inflammation (nociception) but with several superimposed components, including hyperalgesia, abnormal cortical perception, and psychological factors.

Endometriosis and estroprogestins: the chicken or the egg causality dilemma.

Dysmenorrhea as a reason to initiate estroprogestins is significantly more common in women with endometriosis than in women without the disease. This might explain the previously reported mild association between endometriosis and past use of oral contraceptives.