Seminars in reproductive medicine

The role of the endometrium is to establish and maintain pregnancy. Endometrial receptivity is established during the mid-secretory phase, between cycle day (CD) 20 to 24, or 6 to 10 days after ovulation. In some cases of infertility or rec…

An increasing body of evidence suggests that environmental exposures are adversely influencing female fecundity and fertility. Endocrine-disrupting compounds (EDCs) are of particular concern, due to their ability to interfere with the body'…

Asoprisnil (J 867; benzaldehyde, 4-[(11beta, 17beta)-17-methoxy-17-(methoxymethyl)-3-oxoestra-4, 9-dien-11beta-yl]-, 1-oxime) is the prototype of a novel class 11beta-benzaldoxime-substituted selective progesterone receptor modulators (SPRM…

Progesterone, acting primarily via the progesterone receptor (PR), plays an essential role in the regulation of female reproduction. Steroidal progestins (i.e., PR agonists) are commonly used in women's health, such as in contraception and …

Aromatase p450 (p450arom) is the key enzyme for biosynthesis of estrogen, which is an essential hormone for the establishment and growth of endometriosis. There is no detectable aromatase enzyme activity in normal endometrium; therefore, es…

Apoptosis is a physiologic process that deletes unwanted cells without inducing an inflammatory reaction. Survival of endometriotic implants is associated with decreased apoptosis and an inflammatory environment. The most widely accepted th…

The pathogenesis of endometriosis remains poorly defined. The interaction of endometrium with peritoneum is an important aspect of the disease process. Cell adhesion molecules (CAMs) are transmembrane receptors that facilitate intercellular…

Endometriosis is a common disorder of women of reproductive age, yet diagnosis of this condition is often problematic. The most frequent clinical presentations of endometriosis include dysmenorrhea, pelvic pain, dyspareunia, infertility, an…

There are many arguments to support the hypothesis that there is a causal relationship between the presence of endometriosis and subfertility. These arguments are reviewed in this article and include: (1) an increased prevalence of endometr…

Endometriosis is a common gynecologic disorder characterized by the presence of endometrial tissue outside the uterine cavity. Although no single theory can explain all cases of endometriosis, the most commonly accepted theory is Sampson's …

Estrogen is an extremely potent mitogen for endometrium and endometriosis. Progesterone, on the other hand, inhibits the mitogenic action of estrogen on endometrium and enhances differentiation. These antiproliferative and differentiative e…

Endometriosis is a common gynecologic problem of unknown etiology. Estrogen dependence and immune modulation are established features of this disease, and environmental contaminants have been suggested to play a role in the pathobiology of …

Endometriosis is an estrogen-dependent condition that affects 5 million American women; however, its etiology is not fully understood. The development of the baboon model of endometriosis provides an extremely powerful tool to investigate t…

There is increasing evidence that endometriosis is inherited as a complex genetic trait in which multiple genes conferring disease susceptibility interact with each other and the environment to produce the phenotype. Research groups worldwi…

Endometriosis is a benign, estrogen-dependent disorder that has multifactorial components presumed in its pathogenesis. The molecular mechanisms underlying endometrial tissue attachment to the peritoneal surface or metaplasia of the mesothe…

Retrograde menstruation represents a plausible explanation for the development of most cases of endometriosis; nevertheless, additional factors must contribute to the development of disease in only 10 to 20% of women. The discriminating fac…

The medical treatment of endometriosis is a critical aspect of the therapeutic approach to this disease. Past methods have been based upon systemic hormonal alterations, resulting in suppression of this estrogen-responsive disorder. Treatme…

The efficacy of medical and surgical treatment of endometriosis-associated infertility and pelvic pain is a source of questions and controversies. Complete resolution of endometriosis is not yet possible, but therapy has essentially three m…

Surgical management of endometriosis has assumed a prominent role in treating endometriosis-associated infertility and pain. Given the relative lack of prospective, randomized, controlled studies, firm conclusions regarding optimal treatmen…

Although numerous studies have attempted to elucidate the implication of endometriosis for infertility, this matter still remains unexplained. Diverse clinical approaches based on assisted reproduction techniques have produced conflicting r…

Aromatase (P450arom) catalyzes the conversion of testosterone to estradiol, androstenedione to estrone, and 16a-hydroxylated dehydroepiandrosterone to estriol. P450arom is encoded by the human CYP19 gene (15q21.1) spanning about 123 kb with…

The experience of 6 million Norplant users has led to several more advanced implants. Implanon is a single-rod implant system containing a low androgenic progestin and requires 1 to 2 minutes for insertion and removal. Like other implants, …

The oral contraceptive pill is one of the most extensively studied medications ever prescribed. The health benefits are numerous and outweigh the risks of their use. Definitive evidence exists for protection against ovarian and endometrial …

The intrauterine release of levonorgestrel (LNG) alters the function of the endometrium. This phenomenon offers special health benefits for users and a manner of local intrauterine therapy. In this review we discuss use of LNG-releasing int…

A possible association between endometriosis and spontaneous abortion has been suggested in mostly uncontrolled and/or retrospective studies. Some controlled studies evaluating the association between endometriosis and spontaneous abortion …