Recent Advances in Infertility and Endometriosis
A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".
Deadline for manuscript submissions: closed (28 April 2022) | Viewed by 2624
Special Issue Editors
Interests: infertility; IVF; endometriosis; PCOs; obstetrics; prenatal diagnosis; ultrasound
Special Issue Information
Dear Colleagues,
Endometriosis is a chronic disease defined by the presence of endometrial-like tissue, glands, and stroma in ectopic areas depending directly on estrogens. Several pathogenetic theories have been proposed to explain the origin of the pathology, including a crucial role of epigenetic, immune, and hormonal alteration. Moreover, recent evidence has emerged about the role of the peritoneal homeostasis imbalance, which seems to create a permissive inflammatory environment for the progression of the disease. It has been estimated that 10% to 15% of women of reproductive age struggle with endometriosis. Indeed, the disease represents the most common gynecological cause of severe pelvic pain. Endometriosis is also included among the female causes of infertility.
Endometriosis-related infertility may depend on several factors: low number of monthly intercourses due to severe dysmenorrhea and deep dyspareunia, pelvic adhesions altering the tubes’ anatomy and position, peritoneal inflammation, impaired oocyte quality and ovarian reserve, as well as endometriosis cysts. Endometriosis diagnosis may be easily achieved by ultrasound scan performed by expert operators; however, the diagnostic gold standard remains laparoscopy with eventual biopsy for suspicious lesions. With regards to therapy, medical treatment may be useful to solve endometriosis symptoms with the aim of abolishing the menstrual flow using progestins, oral contraceptives, and gonadotropin-releasing-hormone agonists to reduce pelvic pain. However, this does not represent the definitive solution, especially in case of infertility. Surgical treatment consisting of laparoscopy may help to reduce or eliminate pelvic pain due to pelvic adhesions or deep pelvic endometriosis foci, and can be conservative or radical, depending on the woman’s reproductive goals. Nonetheless, despite the advances in the fertility field and assisted reproductive techniques, endometriosis remains a major therapeutic challenge in gynecological and infertility routine. Indeed, there is no strong consensus on whether women who desire to conceive should undergo medical or surgical treatment, or at which stage of endometriosis these treatments should be suggested. On the other hand, it has to be mentioned that the in vitro fertilization (IVF) outcomes of patients with endometriosis are often poor.
The aim of this Special Issue is to provide high-quality data regarding the treatment of patients affected by endometriosis-related infertility with the goal of providing clinicians with therapeutic real-life practices supported by evidence-based medicine.
Prof. Dr. Marco Palumbo
Dr. Federica Di Guardo
Guest Editors
Manuscript Submission Information
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Keywords
- endometriosis
- infertility
- evidence-based medicine
- PCOS
- obstetrics
