Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far

Uterine adenomyosis is a benign disease, commonly encountered in reproductive-age women and responsible for chronic pelvic pain, abnormal uterine bleeding, and infertility. Although the exact origin and pathogenic mechanisms involved in adenomyosis still need to be elucidated, significant progress has been made over recent years. Ever since the theory of endometrium invaginating the myometrium via a traumatized interface was first proposed, numerous molecular mechanisms have been reported to participate in this process. At the same time, an alternative theory has suggested de novo development of adenomyotic lesions from metaplasia of Müllerian remnants or adult stem cells. Hence, our understanding of the pathogenesis of adenomyosis has been greatly enhanced and is anticipated to pave the way for development of an effective and safe treatment. The goal of this review is to analyze current knowledge on the origin and pathogenic mechanisms of adenomyosis, ranging from the most widely accepted theories to newly reported data. Similar content being viewed by others

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The authors thank Mira Hryniuk for reviewing the English language of the article. Funding This work was supported by grants from the Fonds National de la Recherche Scientifique de Belgique (5/4/150/5 grant awarded to Marie-Madeleine Dolmans), PregLem via the Fondation Saint-Luc (grant awarded to Christina Anna Stratopoulou) and donations of the Ferrero Family. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of Interest CAS and MMD have no conflict of interest to declare. JD is a member of the SAB of ObsEva and PregLem. Research Involving Human Participants and/or Animals Non applicable. Informed Consent Non applicable. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Stratopoulou, C.A., Donnez, J. & Dolmans, MM. Origin and Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far. Reprod. Sci. 28, 2087–2097 (2021). https://doi.org/10.1007/s43032-020-00361-w Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-020-00361-w