0013-7227/08/$15.00/0 Endocrinology 149(3):1180–1189 Printed in U.S.A. Copyright © 2008 by The Endocrine Society doi: 10.1210/en.2007-1168 Cyclooxygenase-2 Regulates Survival, Migration, and Invasion of Human Endometriotic Cells through Multiple Mechanism

by the presence of functional endometrial glandular epithelium and stroma outside the uterine cavity (1–4). Endometriosis usually develops in the pelvic organs such as the peritoneum, ovaries, fallopian tubes, outside surface of the uterus, membranes and ligaments of the uterus and pelvis, and the pouch of Douglas (1, 2). Endometriosis affects up to 20 % of women of childbearing age and is associated with dysmenorrhea, dyspareunia, noncyclic pelvic and abdominal pain, subfertility, infertility, and increased pelvic cancer susceptibility (1, 2, 5). The incidence of endometriosis is increased up to 40–60 % higher in women with dysmenorrhea and 30–40 % higher in women with subfertility (1, 2). At the time of clinical presentation, most women are experiencing advanced stages of endometriosis (1, 2). Laparoscopic examination is the only diagnostic method currently available. The available treatment options are also limited; drugs