By Eylül GÜNThe Role of Uterine Contractility in Endometriosis and Adenomyosis
By Eylül GÜN
Uterine peristalsis, crucial for functions like menstruation and embryo transport, is regulated by hormonal fluctuations throughout the menstrual cycle. Altered peristalsis may contribute to reproductive disorders such as endometriosis and adenomyosis. Abnormal uterine contractility patterns, including hyperperistalsis, may help explain…
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By Selma OransayKnowledge synthesis of the "Relevance of Endometriosis Diagnostic Tools"
By Selma Oransay
Spiers et al. from the Department of Obstetrics and Reproductive Medicine at Angers University Hospital in France identified significant diagnostic challenges and the absence of definitive diagnostic tools for endometriosis. In response, they evaluated existing medical literature to enhance diagnostic…
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Endometriosis: Investigating Theoretical Causes and Pathogenesis
By Selma Oransay
Understanding the etiology of endometriosis is crucial for preventing its occurrence and minimizing the significant health burdens it imposes on women. As current treatment options are limited and often lead to severe side effects, identifying potential causes can empower women…
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By Nasuhi Engin AydinThe most influential adverse effects of endometriosis
By Nasuhi Engin Aydin
Academicians from the Queen’s University, Ontario Canada led by Dr. Velez published their population-based cohort study related to pregnancy complications in a recent issue of the Journal of Obstetrics and Gynaecology Canada. This population-based cohort study analyzed the association between endometriosis and…
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By Özge ÖzkayaEndometriosis Prevalence High Among Women With Unexplained Infertility
By Özge Özkaya
The prevalence of endometriosis and tubal abnormalities is still high among patients with unexplained infertility, according to a new study published in the scientific journal Reproductive BioMedicine Online. “The high prevalence of endometriosis in this population is important for decision-making…
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Ovarian Endometrioma Does Not Affect Egg Quality, Study Suggests
By Özge Özkaya
Ovarian endometrioma could decrease oocyte yield in patients undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), according to a new literature review and meta-analysis published in the scientific journal Reproductive BioMedicine Online. However, it does not seem to…
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Rare but clinically important diagnosis; Herlyn-Werner-Wunderlich syndrome
By Nasuhi Engin Aydin
The staff of the Department of Ultrasonography, Third Xiangya Hospital Central South University, Hunan, China have published their case series of the rare Herlyn-Werner-Wunderlich syndrome (HWWS) in a recent issue of Reproductive Sciences. HWWS, is a rare genital tract anomaly…
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Retrograde Menstruation Theory Through Müllerian Anomalies
By Selma Oransay
The pathogenesis of endometriosis is still under debate. Sampson also described this condition as "developmentally misplaced endometrial tissue" in 1925. To evaluate the theories of pathogenesis, Vercellini et al. from the Academic Center for Research on Adenomyosis and Endometriosis at…
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Study Sheds Light on Effect of Endometriosis and Infertility on Couples
By Özge Özkaya
Endometriosis and infertility are significantly associated with partnership and sexuality satisfaction, according to a new study published in the scientific journal Archives of Gynecology and Obstetrics. However, the large overlap between endometriosis and infertility underscores the fact that more research…
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Improving fertility in peritoneal endometriosis
By Selma Oransay
Endometriosis is the most common gynecologic disease that affects 10-15% of women in their reproductive age. The causal relationship between endometriosis and infertility is not clear yet, but adhesions and anatomical distortions due to the progression of the disease are…
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The need for fertility preservation in women with endometriosis
By Selma Oransay
A variety of pathologies such as adhesions, inflammation, modified pelvic anatomy, and altered ovarian reserve are among the causes of infertility in women with endometriosis. Additionally, these patients experience suboptimal outcomes characterized by reduced pregnancy rates when they undergo assisted…
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A concerning link between endometriosis and cardiovascular disease.
By Selma Oransay
Endometriosis is a disease characterized by endometrial-like tissues outside the uterus, which causes inflammation, scarring, and adhesion formation. The pathologic process of forming those adhesions releases proinflammatory molecules, cytokines, and growth factors that may have systemic effects. Recent research, for…
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The location of adenomyosis, and recurrent abortion
By Selma Oransay
ESHRE defines repeated pregnancy loss (RPL) as the loss of pregnancies with two or more weeks of gestation. Adenomyosis is the presence of ectopic endometrium, in the myometrium. High-resolution transvaginal ultrasound and sonographic criteria can help to diagnose the disease…
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Do I Need Assisted Reproduction to Become Pregnant After Endometriosis Surgery?
By Özge Özkaya
Researchers from Argentina developed a decision tree that can help identify patients who might need assisted reproduction techniques to become pregnant following endometriosis surgery. This way, the time between surgery and pregnancy could be minimized and the overall outcome may…
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Long-term Dienogest Treatment and the Chance of Conceiving With IVF
By Özge Özkaya
It is not clear whether long-term treatment with dienogest before in vitro fertilization (IVF) affects pregnancy and live birth rates in women with endometriosis, according to a new study published in the Journal of Obstetrics and Gynaecology Canada. “Given limited…
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Early use of hormonal contraceptives and the probability of endometriosis diagnosis later in life
By Selma Oransay
Hormonal contraceptives are the first-line medical treatment of endometriosis. If an adolescent has chronic pelvic pain and is an "unresponder" to hormonal therapy, the likelihood of having an "endometriosis diagnosis" is higher. This sign should warn clinicians about endometriosis diagnosis…
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By Hale Goksever CelikPsychological effect of endometriosis due to chronic pelvic pain
By Hale Goksever Celik
The most common symptoms of endometriosis are dysmenorrhea, dyspareunia, and chronic pelvic pain, all of which affect the quality of women’s lives. Early diagnosis and management are important as endometriosis impairs the quality of life of patients and creates a…
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Clinical awareness for endometriosis in infertility should be surged
By Nasuhi Engin Aydin
A team of researchers from multiple centers including Stanford University and Swiss Federal Laboratories, led by Dr.Camran Nezhat have published their cross-sectional retrospective study on endometriosis and unexplained infertility association. This research paper appeared in a recent issue of the Journal…
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Fertility outcomes after discoid excision for colorectal endometriosis.
By Selma Oransay
Colorectal endometriosis is one of the most severe forms of deep endometriosis, composing 85% of all bowel lesions. Radical treatment is segmental resection of the bowels, which can cause postoperative severe complications such as rectovaginal fistula and voiding dysfunctions that negatively…
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What Happens to all Those Frozen Eggs?
By Özge Özkaya
The rate of return to use previously vitrified oocytes is notably low even though there is an increase in the number of patients pursuing oocyte cryopreservation, found a new study published in JAMA Network Open. According to the authors of…
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Spontaneous Conception After Deep Endometriosis Surgery
By Selma Oransay
Deep endometriosis is a severe form of endometriosis where lesions invade deeper than 5 mm into subperitoneal space. Surgical management of the disease is a challenging task requiring a multi-disciplinary approach and significant expertise in the field. Anastomotic leaks, fistula,…
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Should I Have Endometriosis Surgery Before IVF-ICSI?
By Özge Özkaya
The live birth rate per in vitro fertilization (IVF) or intrauterine sperm injection (ICSI) cycle was significantly reduced in women who underwent surgery to treat endometriosis before the procedures, found a new study published in the scientific journal Reproductive Sciences. “These…
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Ovarian adhesion prevention with polytetrafluoroethylene during endometrioma surgery.
By Selma Oransay
The World Health Organization defined infertility as the inability to conceive after 12 months of regular unprotected intercourse or after six months of fertility-focused intercourse. Depending on the chronic inflammatory character and causing adhesion formations within the peritoneum, endometriosis is…
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"Ovarian Reserve Markers" in Peritoneal Endometriosis
By Selma Oransay
Endometriosis-related subfertility is attributed to multiple factors, including mechanical obstructions, adhesions, pelvic inflammation, and diminished ovarian reserve. Serum anti-Mullerian hormone (AMH) levels and ovarian antral follicle counts (AFC) currently serve as fertility markers to diagnose decreased ovarian reserve and failure.…
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Embryo Morphokinetics of Endometriotic Patients by Time Lapse Monitoring
By Selma Oransay
Many studies showed adverse effects of endometriosis on oocyte quality due to increased apoptosis and dysregulation of molecular pathways related to the development and growth of granulosa cells resulting on developmental arrest in embryos of women with endometriosis. Time-lapse monitoring…
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A non-invasive test to determine the risk of endometriosis in women having chronic pelvic pain or unexplained infertility
By Hale Goksever Celik
Women having endometriosis may suffer from chronic pelvic pain and/or infertility, both of which diminish the quality of life in these women. Minimalization of the time between the onset of symptoms and diagnosis is essential to improve patients’ lives. However,…
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Deep infiltrating endometriosis and postoperative pregnancy outcomes
By Selma Oransay
Although the current ESHRE guidelines state that there is no strong evidence to support surgical intervention to improve the spontaneous pregnancy rate in women with deep infiltrating endometriosis and advise Assisted reproduction technology irrespective of the severity of endometriosis, several studies…
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The overlap of endometriosis and polycystic ovarian syndrome
By Eylül GÜN
Polycystic ovarian syndrome (PCOS) is one of the most common causes of female subfertility similar to endometriosis. It has been hypothesized that owing to the underlying pathophysiological mechanisms, women with endometriosis are at a greater risk of having PCOS than…
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Omitted facet of endometriosis : mental health related to stigma
By Nasuhi Engin Aydin
A team of clinical psychologists involved in women’s health led by Deniz Kocas has published a recent review on the mental health aspect of endometriosis patients in the European Journal of Obstetrics & Gynecology and Reproductive Biology. Endometriosis is a notoriously…
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Endometrioma surgery and the ovarian reserve
By Selma Oransay
Traditionally, cystectomy is the gold standard for surgical approach owing to the reduced risk of recurrence. Still, it may lead to a reduction in postoperative ovarian volume and can be a cause of ovarian failure. The recent conservative surgical management of…
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Women With Endometriosis at a Higher Risk of Pregnancy Complications
By Özge Özkaya
Apart from having difficulties conceiving, women with endometriosis also seem to have a significantly higher risk of adverse pregnancy outcomes. This is according to a new population-based study published in the Journal of Clinical Medicine. It is already known that…
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Assessing endometrial receptivity using menstrual blood samples in patients undergoing in-vitro fertilization
By Eylül GÜN
Endometrial receptivity is the endometrium's capacity to allow the embryo the chance to adhere, infiltrate, and develop while ensuring an ideal microenvironment. When impaired, it is one of the two major factors contributing to infertility along with embryo quality by…
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Study May Explain How Tubal Endometriosis Causes Infertility
By Özge Özkaya
Tubal endometriosis damages the epithelial ultrastructure of the fallopian tubes or the tubes connecting the ovaries to the uterus along which an egg travels each month ready to be fertilized by a sperm cell. This could help explain why tubal…
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Moderate-to-severe Endometriosis and "The Cumulative live birth rate" in IVF Cycles
By Hale Goksever Celik
Infertility is one of the major symptoms in women with endometriosis. The incidence of endometriosis is approximately 10% in reproductive-aged women and up to 40-50% in infertile women. There are multifactorial mechanisms resulting in endometriosis-associated infertility such as anatomic distortion, impaired…
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A Starch-Based Gel Barrier Reduces Pain and Improves Fertility After Endometriosis Surgery
By Özge Özkaya
The development of pain was reduced in women with endometriosis who underwent surgery for deep infiltrating endometriosis (DIE) resection and the "gel barrier 4DryField® PH" was used during the operation, according to results from a randomized controlled trial. Moreover, fertility was improved. "4DryField® PH"…
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Limitations of current surgical classification systems for endometriosis.
By Selma Oransay
Many classification systems for endometriosis have been developed since the 1970s, and in a 2021 review, more than 20 of those systems were identified. The best-known and most frequently used are rASRM (revised American Society of Reproductive Medicine), the Enzian…
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When to start ART after laparoscopic treatment of endometriosis?
By Selma Oransay
Laparoscopy combined with histopathologic confirmation of endometriosis is the reference standard for diagnosing endometriosis. Additionally, laparoscopic surgery is considered the most effective way to approach infertility induced by endometriosis. The surgical factors influencing the outcome of treating the infertility of…
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Neuroendocrine pathway in endometriosis-related infertility
By Eylül GÜN
Dr. Robert Taylor from Jacobs School of Medicine, University at Buffalo presented on the newly defined neuroendocrine pathway and its role in endometriosis-related infertility and how implantation and pregnancy establishment might be disrupted in endometriosis at the Annual International Medical Conference of…
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Integrative medical management of endometriosis
By Selma Oransay
This lecture entitled "Integrative Medical Management of Endometriosis" was presented by Dr. Pinar Kodaman, Director of the endoscopic reproductive surgery program and Assoc. Professor of Clinical ObGyn and Reproductive Sciences at the Yale School of Medicine. In addition to surgery which…
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Stem cells could be a good choice for therapeutic steps in many gynecologic disorders, including endometriosis
By Nasuhi Engin Aydin
Dr. Liu from the First Hospital of Jilin University, China, and colleagues from China and the USA have published their comprehensive review on the therapeutic gateways of stem cells in female genital tract disorders in a recent issue of Life…
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Antioxidant astaxanthin has promising effects on endometriosis-related infertility.
By Nasuhi Engin Aydin
Dr. Rostami and colleagues from the Tehran University of Medical Sciences, Iran, have published a pioneering clinical study on the effects of antioxidant astaxanthin supplementation in infertile endometriosis patients in the scientific journal named Frontiers in Endocrinology. A complicated network…
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Transvaginal Hydro laparoscopy for diagnosing and treatment of early stages of endometriosis
By Selma Oransay
Transvaginal hydro laparoscopy is a minimally invasive procedure that allows the exploration of the female pelvis. An obliterated Douglas pouch by a fixed retroverted uterus, an ovarian endometrioma greater than 2 cm, and the presence of deeply infiltrated endometriosis are…
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First-line surgery or first-line ART: A real challenge both for the clinicians and infertile women having DIE without colorectal involvement
By Hale Goksever Celik
Deep infiltrating endometriosis (DIE) is defined as the presence of endometriotic lesions over 5 mm in depth under the peritoneal surface. These women suffer from chronic pelvic pain, dysmenorrhea, dyspareunia, chronic pelvic pain, bloody or painful bowel movements, and infertility. There…
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Does Endometriosis Surgery Increase the Rate of Pregnancy?
By Özge Özkaya
Surgery to treat colorectal endometriosis leads to a high rate of pregnancy following the operation, found a new study published in the Journal of Minimally Invasive Gynecology. The authors of the study said, “studies with a high level of evidence…
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Histopathologic examination always has the final word in tubal endometriosis
By Nasuhi Engin Aydin
Hai-Ning Jiao and coworkers from the Department of Obstetrics and Gynecology of Shanghai Jiao Tong University School of Medicine, China, reported the salient features of 30 tubal endometriosis cases in the World Journal of Clinical Cases. Tubal endometriosis is characterized…
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Comparison of two surgical approaches for endometriosis.
By Selma Oransay
Endometriosis is one of the causes of infertility in women. But the pathophysiology of infertility caused by endometriosis is not yet clear. Hormonal disorders, abnormal peritoneal function, distorted pelvic anatomy, and multiple cesarean deliveries are among the accused. Dr. Li…
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How Common is Adenomyosis Among Subfertile Women?
By Özge Özkaya
Around 10% of women who have reduced fertility have isolated adenomyosis, according to a new study published in the scientific journal Ultrasound in Obstetrics & Gynecology. The prevalence of the disease seems to vary according to the presence of endometriosis…
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Comparison of different IVF stimulation protocols for pregnancy success in infertile endometriosis patients
By Hale Goksever Celik
Women with endometriosis may suffer from reproductive problems up to an incidence of 50%. Several pathophysiological mechanisms including anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis and sperm movements are the most responsible for the development of endometriosis-associated infertility.…
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The optimal endometrial preparation protocol in FET cycles of women with endometriosis.
By Selma Oransay
Endometriosis can create infertility and may require treatment with assisted reproductive technology (ART) to induce pregnancy. However, the current literature rarely discusses the optimal endometrial preparation protocol in thawed-frozen embryo transfer (FET) cycles for endometriotic patients. Dr.Jin. group from the Reproductive…
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Diaphragmatic Endometriosis: a Call for Awareness
By Nasuhi Engin Aydin
Dr. Pagano and colleagues from the Department of Gynecology and Obstetrics, University of Bern, Switzerland, have published a prospective cohort study on diaphragmatic involvement in endometriosis patients in a recent issue of “The Journal of Minimally Invasive Gynecology”. Endometriosis is…
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Sexual function in infertile women with PCOS and endometriosis
By Hale Goksever Celik
Women with endometriosis suffer from several symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility which have a detrimental effect on their quality of life. Sexual dysfunction also is a common problem for endometriosis patients due to complex…
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Endometriosis, Age, and Ovarian Reserve
By Özge Özkaya
The effect of endometriosis on ovarian reserve can be enhanced with older age, according to a new study published in the International Journal of Gynecology & Obstetrics. This finding is important because it can help clinicians guide their patients in…
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Does endometrioma size have an effect on IVF/ICSI outcomes?
By Hale Goksever Celik
Assisted reproductive technologies including IVF/ICSI can be suggested as the therapeutic option in women with endometriosis-associated infertility. In literature, there is a controversy regarding the influence of endometrioma size on IVF/ICSI outcomes. The group led by Drs Chapron and Santoulli…
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Adenomyosis and the anti-mullerian hormone levels
By Eylül GÜN
The presence of endometrial glands and stroma in the myometrial layer of the uterus is called adenomyosis. It is considered a form of endometriosis and affects up to 35% of women with varying symptomatology, from asymptomatic to subfertility. For a…
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Fallopian tube occlusion in infertile women with endometriosis
By Hale Goksever Celik
Women with endometriosis suffer from fertility problems with an incidence of 40-50%. Among the pathophysiologic mechanisms resulting in impaired fertility in women with endometriosis, distorted pelvic anatomy due to adhesions, impaired follicular quality-quantity, dysfunction of tubal peristalsis, and implantation problems…
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Endometriosis and IBS Have Different Comorbidities
By Özge Özkaya
Comorbidities of endometriosis and irritable bowel syndrome (IBS) are different despite several overlapping symptoms, according to a new study published in the scientific journal Human Reproduction. These comorbidities are usually related to the organ systems that are primarily involved in…
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Time has come to learn more about endometriosis and take action!
By Eylül GÜN
It has been a long time since endometriosis was defined. Extensive population studies have shown that around 10% of women suffer from this condition. Depending on its severity, it alters the various functions of the body and causes the patients…
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Does the timing of endometriosis diagnosis affect optimal infertility treatment?
By Selma Oransay
Based on a retrospective population-linked data study in "Human Reproduction", the ESHRE journal club featured a detailed discussion with 50 participants, patients’ representatives, and experts (Paola Vigano´, Mathew Leonardi, Thomas D’Hooghe, Louise Hull), together with the authors of the original article, mainly…
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Endometriosis-associated infertility: How to manage?
By Hale Goksever Celik
Although the underlying reason for endometriosis has not been fully established, there is an association between endometriosis and infertility. Endometriosis is thought to be involved in 40-50 percent of infertility cases. However, natural conception can still occur even in women…
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Fertility assessment and surgical approach in endometriotic patients.
By Selma Oransay
The prevalence of endometriosis is around 50-70% in women with pelvic pain, and it has been reported as 50% in patients with infertility. Severe adhesive disease associated with advanced endometriosis is a cause of fertility impairment. The relationship between endometriosis…
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The effect of chronic endometritis on pregnancy outcomes in infertile women having minimal/mild endometriosis
By Hale Goksever Celik
Endometriosis is an estrogen-dependent disease that is frequently diagnosed in reproductive-aged women. Infertility can be associated with endometriosis in these women depending on several pathophysiologic mechanisms such as anatomic distortion, and implantation failure. Thus pregnancy rate is so important, especially…
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Are my Eggs Good Enough for IVF?
By Özge Özkaya
There does not seem to be any difference in the rate of live births between women with endometriosis who became pregnant following IVF using their own eggs or eggs obtained from a donor. This suggests that oocyte quality may not…
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The association between inflammatory cytokines and fertility in women with endometriosis
By Hale Goksever Celik
Women with endometriosis suffer not only from a broad spectrum of symptoms including pain including dysmenorrhea, dyspareunia, and chronic pelvic pain but also fertility problems. Endometriosis-associated infertility develops depending on a combination of several mechanisms such as distorted pelvic anatomy,…
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The consequence of COVID-19 pandemic on endometriosis patients
By Selma Oransay
The relevant policies and restrictions concerning Covid-19 have prevented patients from accessing medical care. Similarly, standard care for endometriosis patients has also been negatively impacted by postponed or canceled appointments and suspended surgeries across the countries. Women trying to cope…
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The evaluation of sexual dysfunction in infertile women
By Eylül GÜN
Infertility constitutes a serious health problem in women and men worldwide. The most common causes of women’s infertility are reported to be endometriosis and polycystic ovarian syndrome. The prevalence of infertility in women with endometriosis is as high as 50%.…
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Endometriosis diagnosis and management based on the best available evidence from published literature
By Selma Oransay
ESHRE, "European Society of Human Reproduction and Embryology" published a Guideline for the diagnosis and treatment of endometriosis in 2005 and then revised it in 2013. Based on new research and development there was a need to renew the last…
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The underlying reason of implantation failure in women with endometriosis-associated infertility
By Hale Goksever Celik
Endometriosis is most frequently encountered in reproductive-aged women, with a prevalence of 10-15% in the general population. However, endometriosis is more frequently diagnosed in infertile women, with a prevalence of 25-40%. Although the exact mechanism explaining the association between endometriosis…
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International Working Group's review on endometriosis classification systems
By Nasuhi Engin Aydin
International Endometriosis Working Group including AAGL, ESHRE, ESGE, and WES published a comprehensive review on endometriosis classification, staging, and reporting systems in a recent issue of the journal named "Facts, Views & Vision in Obstetrics and Gynecology". Classification and staging…
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A comparison of endometriosis Classifications: rASRM, EFI or Enzian?
By Selma Oransay
None of the endometriosis classifications provide a clinically valuable system since the very first description of the disease in 1860. One unique terminology to describe the localization and the extension of the disease is needed, which should be the same…
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Surgery before in-vitro fertilization – Is it beneficial in patients with deep endometriosis?
By Eylül GÜN
Deep pelvic endometriosis is thought to be related to infertility by altering the pelvic environment and anatomy due to pelvic adhesions, and the changes in endometrial receptivity contribute to it. The discussion on whether the surgical intervention was beneficial started…
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Quality of life assessment in women with endometrioma
By Eylül GÜN
Like most chronic diseases, endometriosis poses a significant risk of diminishing the quality of life in patients suffering from it, particularly with its most considerable symptom; chronic pelvic pain. Although it is known that endometriosis is more common in East…
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Is intrauterine insemination effective in women having endometriosis-associated infertility?
By Hale Goksever Celik
The most common presenting complaints of women with endometriosis are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Affected women demand therapy for these symptoms of endometriosis, notably fertility problems. Several underlying mechanisms have been proposed to explain endometriosis-associated infertility including anatomic…
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The necessity of laparoscopy for unexplained infertility.
By Selma Oransay
The standard for accepting a couple as "infertile" is the inability to conceive after 12 months of regular unprotected intercourse. When this condition is met, assessing the number of motile sperm in the male partner and certifying the patency at…
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The Role of Endometrial Cytokines on the Infertility in Endometriosis Patients
By Eylül GÜN
The intrauterine microenvironment and underlying immunological mechanisms in endometriosis pathogenesis have been a popular research topic, mainly due to the efforts to comprehend the reason to elucidate infertility that these patients suffer from. Because of their superiority to other immune…
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How likely is it to get pregnant and have a baby after undergoing surgery for high stage endometriosis?
By Eylül GÜN
As one of the most common causes of infertility in women, endometriosis might be surgically interfered with depending on the stage. For Stage I and II endometriosis, surgery is recommended in the latest guidelines to ameliorate fertility rates, however, there…
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Envorinmental metals harmful for female reproductivity
By Selma Oransay
Heavy metals exposure in a wide range of ways is one of the main causes of increased infertility. According to the 2003 National Health Survey, nearly every pregnant woman in the USA is exposed to at least 43 hazardous chemicals…
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Pain alone is not a specific predictor for endometriosis diagnosis
By Hale Goksever Celik
The most common symptoms and signs of women with endometriosis include dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. However, diagnostic delay still occurs due to the broad clinical spectrum of the disease and the absence of non-invasive diagnostic biomarkers. Gordon et…
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The quality of life and mental health in endometriosis patients
By Eylül GÜN
One of the most important aspects of having a chronic illness comes with its relative effect on the patients’ quality of life and mental health status. Being among the most debilitating diseases in women in the reproductive period, endometriosis is…
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How Likely Am I to Conceive After Endometriosis Surgery?
By Özge Özkaya
Women with superficial peritoneal endometriosis and just one type of lesion are more likely to conceive after surgery, according to a new study published in the International Journal of Gynecology and Obstetrics. This is important because patients will be better…
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The higher the Endometriosis Fertility Index, the higher the chance of getting pregnant
By Hale Goksever Celik
The women who desire to get pregnant may also suffer from fertility problems depending on several mechanisms such as anatomic distortion, peritoneal adhesions, tubal dysfunction, impaired quality of oocytes, and impaired endometrial receptivity. One of the most important problems in…
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An Overview on Treatment of endometriosis
By Selma Oransay
There are different guidelines by different gynecological societies for the diagnosis and treatment of endometriosis, which is an extremely complex illness. Kalaitzopoulos and Samartzis et al. from Switzerland worked on and compared six national and two international widely used guidelines to…
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Preoperative Neutrophil-to-Lymphocyte Ratio for prediction of postoperative pregnancy
By Hale Goksever Celik
Among women with endometriosis, 30 to 50 percent are estimated to have infertility, and 25-50% of infertile patients are found to have endometriosis. Anatomic distortion, diminished tubal peristalsis, diminished sperm movements, dysfunctional folliculogenesis, luteal phase dysfunctions, and alterations in endometrial…
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The new Endometriosis Surgical Complexity Classification: AAGL 2021
By Selma Oransay
Multiple endometriosis categorizations have been approved in the recent forty years. The American Fertility Society proposed ASRM with a desire to score the impact of the endometriosis in 1996, which was updated several times later (rASRM), to predict infertility after laparoscopic operations. For…
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By Bahar YukselIt is "pain" that causes sleep disturbances and fatigue in endometriosis patients
By Bahar Yuksel
Endometriosis has been studied previously about its effects on quality of life and the possible effects on sleeping periods. The study conducted by Federica Facchin et al. questioned the reason for endometriosis to cause sleep disturbance. The authors have divided…
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Assisted Reproductive Technology Outcomes in Women with and without Endometriosis
By Selma Oransay
Endometriosis causes infertility in one-third of patients, while in approximately 25-35% of infertile women, the cause is endometriosis. The primary interest and the question of Moss et al. from the University of Queensland, Brisbane, Australia was "the differences in the…
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By Dr. Youngran ParkAwareness is the first step toward endometriosis treatment
By Dr. Youngran Park
We want to reiterate the importance of endometriosis, by handling the paper entitled "Endometriosis awareness: screaming at the top of our voices" published on April 2021 in the journal “Women & Health”. The Endometriosis Awareness Month of 2021 was a little different,…
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Non-invasive Construction of Endometrial Organoids
By Eylül GÜN
Organoids are 3D culture structures established in vitro and they reflect the aspects of the tissue or the organ they represent. They are seen as important tools in the evaluation of normal development, disease course, and the prediction of the…
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The clues for pain and infertility in endometriosis/adenomyosis complex
By Nasuhi Engin Aydin
Drs. Gruber and Mechsner from Charite University-Berlin, Germany published their comprehensive review on pathophysiological background of endometriosis and adenomyosis in the scientific periodical “Cells”. Chronic pain and fertility problems are the main clinical issue in endometriosis and adenomyosis patients. In order to…
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Adenomyosis, fertility, and obstetric outcomes
By Hale Goksever Celik
Adenomyosis is the localization of endometrial glandular and stromal cells within the myometrial wall. Although magnetic resonance imaging has a higher ability to discriminate and identify adenomyosis, transvaginal ultrasonography is a cheaper, more accessible, and practical method in daily clinical practice for…
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MicroRNAs in the pathogenesis of endometriosis and infertility
By Eylül GÜN
The gold standard in the diagnosis of endometriosis is laparoscopy and histopathological diagnosis, however search for a non-invasive method has been ongoing. Some biomarkers such as Cancer Antigen 125 have been thought to be useful, but because of their low…
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Outcomes of chronic pelvic pain of endometriosis after laparoscopic surgery
By Selma Oransay
The prevalence of endometriosis is up to 35-50% among patients with pelvic pain. Among several medical and surgical options to relieve chronic pelvic pain, surgical options are the preferred method but this depends on patients' age, fertility desire, and disease…
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Postoperative ovulation induction in infertile women with minimal to mild endometriosis
By Hale Goksever Celik
Infertility is an important problem that is encountered in 30-50% of women with endometriosis. Several etiopathogenetic mechanisms for the development of reproductive problems in women with endometriosis have been proposed including abnormal peritoneal microenvironment, ovarian dysfunction and/or decreased oocyte quality,…
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Ultrasonographic signs of adenomyosis, surgery and infertility in endometriosis patients
By Bahar Yuksel
Adenomyosis is simply defined as the presence of endometrial glands and stroma within the uterine myometrium and is related to severe menstrual bleeding, pain, and infertility. Previous reports demonstrated the coexisting of endometriosis and adenomyosis is common. In the present…
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Peritoneal Pockets and Endometriosis
By Özge Özkaya
Infertile women with peritoneal pockets had more endometriosis compared to women without pockets according to a study published in the Journal of Obstetrics and Gynaecology Canada. Severe pelvic pain was also associated with the presence of pockets and the presence…
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The need for the standardization of diagnostic protocols for "adenomyosis"
By Nasuhi Engin Aydin
Dr. Squillace and associates from Brasilian Academic and Health Centers published their paper titled “Adenomyosis and in vitro fertilization impacts- a literature review” in a recent issue of "JBRA Assisted Reproduction". As common gynecological ailment adenomyosis frequently coexists with endometriosis.…
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Low-Dose Aspirin as a Potential Treatment for Endometriosis-Related Infertility
By Özge Özkaya
Treatment with low-dose aspirin could downregulate progesterone resistance and increase the expression of leukemia inhibitory factor (LIF) during the implantation window, according to a study that used a rat model of endometriosis. This, in turn, could improve endometrial receptivity and…
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Postoperative infertility management using Endometriosis Fertility Index in endometriotic women
By Selma Oransay
"Endometriosis Fertility Index '' score, described by the World Endometriosis Society in 2017, is a robust score and assists to predict the spontaneous pregnancy rate of women with endometriosis, within 3 years after their operation. Its calculation is possible by patient…
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What Happens to Endometriosis Patients After Endometriosis Surgery?
By Özge Özkaya
Although few patients with endometriosis who undergo a hysterectomy need repeat surgery, up to 25% of them need minor surgery. Around 20% of patients who undergo conservative surgery with ovarian preservation require additional endometriosis surgery. Up to one in three…
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Optimal management of infertility in endometriosis patients
By Hale Goksever Celik
Pelvic pain and infertility are the main symptoms of endometriosis patients. Although the pathophysiological mechanism for infertility is not clearly understood, there are several theories explaining decreased fertility potential in women with endometriosis. Ata and Telek, from Koc and Istanbul Universities…
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The association of chronic endometritis, endometriosis and tubal infertility
By Selma Oransay
Holzer et al. from the Department of Gynecologic Endocrinology and Reproductive Medicine of Medical University of Vienna, Austria, set up apilot prospective cohort study to evaluate the relationship between chronic endometritis, infertility and endometriosis. The results of the study were recently…
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Fertilization rate and pregnancy outcome in IVF cycles of endometriosis.
By Selma Oransay
Endometriosis affects the pelvic cavity, uterus, ovaries and causes impaired fertility as a result. The chronic inflammatory nature of this disease negatively impacts the oocyte quality, maturation, and fertilization. Obviously, fewer oocytes can be harvested in the IVF cycles of…
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Endometriosis, ART, fertility preservation
By Selma Oransay
This review entitled "The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation" was written by Necula et al. from Gynecology and Obstetrics Unit, Biel, Switzerland, and recently published in the journal "Hormone, Molecular Biology and Clinical…
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Endometrial receptivity after the removal of ovarian endometriotic cysts
By Nasuhi Engin Aydin
Mikhaleva and associates from the "Russian Research Institute of Human Morphology" published their results in “Reproductive Sciences” yielding their novel morphological findings of eutopic endometria in patients following surgical excision of endometriotic ovarian cysts. Current therapeutic measures are targeting to…
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Impaired fertility potential in endometriosis patients
By Hale Goksever Celik
Infertility is frequently encountered in endometriosis patients because of anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis and sperm movements. Garcia-Fernandez and García-Velasco, from Edinburgh, UK and Madrid, Spain, published a mini-review titled “Endometriosis and Reproduction: What We Have…
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The improvement of fertility rate and symptoms of superficial endometriosis following laparoscopic peritoneal stripping
By Selma Oransay
Pain, in the form of diverse entities, including dyspareunia, dysuria, dyschezia, is the main symptom of endometriosis patients. The severity of pain is independent of the extent and the location of the disease, and generally causes a negative impact on…
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Live Birth Rate in Women Who Underwent Fresh Embryo Transfer Using Freshly Retrieved Donor Oocytes
By Hale Goksever Celik
One of the important clinical findings in women with endometriosis is reproductive problems. Infertility can be encountered in up to 50% of women with endometriosis and up to 50% of women with infertility can be diagnosed with endometriosis. Several pathophysiologic…
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Postoperative pregnancy rate in infertile women with deep infiltrating endometriosis
By Hale Goksever Celik
Deep infiltrating endometriosis (DIE) is fibrous/muscular infiltration of organs and anatomical structures containing endometrial tissue below the peritoneum regardless of the depth of infiltration. Another definition describes DIE as infiltration of the peritoneum by endometriotic lesions deeper than 5 mm. Pain,…
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KEYNOTE: Excision Without Mutilation: It’s Possible! - Arnaud Wattiez, MD
By Özge Özkaya
In his keynote lecture, Dr. Wattiez talks about the pros and cons of endometriosis surgery and the importance of tailoring endometriosis surgery to individual patients. “Endometriosis is a disease that degrades patient’s wellbeing," Dr. Wattiez says and gives some examples…
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Egg Freezing for Endometriosis: Should she rush - Tomer Singer, MD
By Özge Özkaya
In this presentation, Dr. Tomer Singer, a fertility specialist and the medical director at Shady Grove Fertility in Manhattan, New York talks about egg freezing and its importance for women with endometriosis. He emphasizes the importance of having an endometriosis…
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Implantation failure in endometriosis patients - Jovana Lekovich, MD., PhD.
By Hale Goksever Celik
Endometriosis is one of the leading reasons for infertility due to decreased oocyte/embryo quality, fertilization ability, tubal function, and aberrant endometrial receptivity. Whether this failure is caused by oocyte/embryo or eutopic endometrium is one of the investigated topics in endometriosis…
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Limits of endometrioma surgery in infertility patients - Liselotte Mettler, MD, PhD
By Selma Oransay
The removal of endometrioma may affect ovarian reserve because healthy follicles near endometrioma could also be excised during this procedure. Another concern about the ovarian reserve is that it may be already low before the surgery. Anti Mullerian Hormone (AMH)…
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In vitro fertilization protocols in endometriosis patients - Pinar Kodaman, MD., PhD.
By Hale Goksever Celik
Infertility is frequently encountered in endometriosis patients because of anatomic distortion, alterations in endometrial receptivity, diminished tubal peristalsis, and sperm movements. Even though the disease stage and presence of endometrioma is negatively correlated with infertility, it is unpredictable which women…
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Endometrioma size and anti-Müllerian hormone levels
By Hale Goksever Celik
Endometriotic lesions are encountered in different locations in the pelvic cavity, including but not limited to the ovaries, the pouch of Douglas, the ureters, the bladder, and the bowel. Cystic endometriosis lesions located in the ovary are called "endometrioma". Endometriomas have…
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Endometriosis and Natural Killer Cell Immunity
By Dr. Youngran Park
It is known that approximately 25 to 50% of infertile women have endometriosis, and 30% to 50% of the women with endometriosis have infertility and recurrent pregnancy loss. Previous studies have shown that women suffering endometriosis have abnormal NK cell…
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It is time for non-invasive tests for peritoneal endometriosis diagnosis
By Nasuhi Engin Aydin
Maria Szubert with colleagues from Lodz Medical University, Poland, investigated the possibility of potential diagnostic biomarkers in the eutopic endometrial tissue from peritoneal endometriosis patients and published their results in the "Journal of Gynecology Obstetrics and Human Reproduction". Currently, diagnostic…
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Fallopian tube endometriosis
By Bahar Yuksel
Endometriosis affects various tissues including pelvic and extra-pelvic organs. Fallopian tube endometriosis is not a widely studied topic in endometriosis, hence the real incidence is unknown as not all studies evaluate microscopically diagnosed Fallopian tube endometriosis. In the retrospective database…
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Stem cell and exosome therapy
By Dr. Youngran Park
These days, two experimental methods, stem cell, and exosome therapy are getting more attention. Stem cell therapy has shown promising effects in regenerative medicine, including myocardial infarction, nervous system impairment, retinal damage, and liver diseases. Recent studies showed that stem…
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By Yu YuIron overload in follicular fluid in Endometriosis
By Yu Yu
Around 20-50% of women with endometriosis have an infertility issue. Assisted reproductive technology (ART) is a common procedure to assist women with endometriosis to become pregnant. However, one major problem remains that women with endometriosis tend to have fewer oocytes…
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International experts commentary for assisted fertility treatment facilities amidst COVID-19
By Nasuhi Engin Aydin
A multinational and multi-institutional commentary led by Dr. Alviggi from Italy and Dr.Esteves from Brazil has addressed important issues on assisted reproductive technology treatment amid COVID-19 lockdown suggesting remedies in the journal of "Reproductive Biology and Endocrinology" May 2020 issue.…
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By Irem OnurIs oocyte cryopreservation useful for fertility preservation in ovarian endometriosis?
By Irem Onur
Women with endometriosis tend to have lower fecundity compared to normal couples. Furthermore, endometrioma itself may reduce the ovarian reserve by altering ovarian physiology in the surrounding healthy ovarian tissue. The treatment for endometrioma is surgical removal in most cases, however,…
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By Nadire DuruCase-control study to develop a questionnaire for early diagnosis of endometriosis
By Nadire Duru
Endometriosis, which affects 5–10% of women of reproductive age, is a chronic gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus, associated with several discomforts such as pelvic pain, menstrual disorders, and infertility. Ultrasound evaluation…
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By Timur SeckinNeglected needs of endometriosis and infertility patients during COVID-19 pandemic
By Timur Seckin
With the global outbreak of the COVID-19, hospitals canceled surgeries and people are afraid of going to hospitals. However, chronic diseases still need to be managed. Rowe H. and Quinlivan J., researchers from Australia, pointed out the neglected needs of…
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Resveratrol for infertility: A frenemy?
By Selma Oransay
Ovarian aging is defined by an age-specific decline of the functional ovarian reserve. Female ovarian reserve declines progressively with increasing chronological age. Chronic damage by reactive oxygen species results in deterioration and aging through mitochondrial dysfunction, telomere shortening, cohesion dysfunction,…
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New Insights on Infertility and Low Success Rates of Assisted Reproduction in Women with Endometriosis
By Özge Özkaya
The fluid surrounding immature eggs waiting to mature and be fertilized by a sperm to lead to pregnancy is different in women with endometriosis compared to those without, according to a study published in Molecular Biology Reports. This could explain,…
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Hysterolaparoscopy Plus Assisted Reproduction Improves Fertility in Women with Endometriosis
By Özge Özkaya
Hysteroscopy and laparoscopic surgery is an effective and reliable therapeutic procedure, confirmed a study published in the "Journal of Clinical Medicine". The approach is even more effective when combined with assisted reproductive techniques such as artificial insemination and in vitro…
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Fertility conservation in women with endometriosis
By Selma Oransay
Endometriosis affects 10-15% of women in their reproductive period and almost half of them may need Assisted Reproductive techniques to conceive. Moreover, increased malignancy risk is threatening the women with severe endometriosis in addition to their decreased ovarian reserve. Due…
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Fertility preservation protocols in women with endometriosis
By Hale Goksever Celik
Infertility is one of the major symptoms in women with endometriosis. Childbearing at a delayed age is preferred by the majority of women recently who consult for the demand for fertility preservation procedures. There are several techniques for fertility preservation…
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Fertility and Oxidative Stress
By Yu Yu
One of the characteristics of endometriosis is oxidative stress caused by an imbalance between the production of reactive oxygen species and their resolution by antioxidants. Increased oxidative stress can lead to the damage of proteins, lipids, DNA and other molecules.…
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The Relationship Between Dyspareunia and Infertility in Endometriosis
By Selma Oransay
Wahl et al. from the Center of Pelvic Pain and Endometriosis British Columbia Women's Hospital, Vancouver, Canada studied with endometriotic patients suffering from dyspareunia who were referred to their center and built a cross-sectional study to investigate the relations between…
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Endometrioma, follicular fluid, oocyte and embryo
By Yu Yu
It is estimated that infertility occurs in more than one-third of women with endometriosis. How endometriosis affects fertility, however, is not clearly known. The follicular fluid provides a microenvironment for oocyte development and impacts embryo quality. Thus, it is believed…
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Preoperative serum CA 125 levels predict the severity of adhesions in endometriosis
By Irem Onur
Lee Y. et al., a group of researchers from Korea evaluated the correlation between preoperative serum markers and pelvic adhesions in endometriosis patients and explored the markers’ clinical value for outcome prediction. They have recently published their study in the…
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By Murat OsmanWhich treatment option improves fertility the most?
By Murat Osman
Endometriosis is a condition that causes anatomic, hormonal, and inflammatory disturbances that may ultimately result in decreased fertility or infertility. It is estimated that 30-50% of women with endometriosis suffer from infertility. Thus, the role of surgical, medical, or expectant…
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Could my Peritoneal Fluid Have a Negative Effect on my Partner’s Sperm?
By Özge Özkaya
The peritoneal fluid of women with endometriosis could negatively affect the quality and functionality of sperm, according to a study by Spanish researchers. This could explain infertility linked to the male partners of women with endometriosis. The knowledge could also…
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The association between endometriosis and ectopic pregnancy
By Hale Goksever Celik
Endometriosis is a chronic inflammatory disease with a broad spectrum of symptoms such as dysmenorrhea, dyspareunia, chronic pelvic pain and fertility problems. It has been understood in the light of scientific evidence that endometriosis is also associated with other poor…
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What we should know in managing infertility related to endometriosis?
By Nasuhi Engin Aydin
Dr. Llarena and associates made a comprehensive review of the causes of infertility in endometriosis and adverse effects of surgical procedures in Clinical Medicine Insights: Reproductive Health. Infertility is an important issue in endometriosis patients and about 30-50 % face infertility.…
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When to do - and when not to do surgery for endometriosis
By Dr. Youngran Park
Endometriosis is an estrogen-dependent disorder. It was estimated to affect about 176 million women in the world and usually causes pelvic pain and infertility. Unfortunately, the current understanding of this disease is very limited. Though there are many remaining questions,…
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Recent advances in the diagnosis and treatment of endometriosis
By Hale Goksever Celik
Endometriosis is an estrogen-dependent disease that is commonly diagnosed in reproductive-aged women. The most common complaints of women with endometriosis are pain and fertility problems. Although many advanced types of research about the etiology, differential diagnosis and treatment have been…
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Hemorrhagic Ascites, Belly-Blood: The cause may be endometriosis!
By Timur Seckin
A paper on the presentation of hemorrhagic ascites in endometriosis patients, written by Bernard et al. from the United States and China, was published in the journal Fertility and Sterility. From 1978 to 2016, the authors found only 37 articles, which describe 42…
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The effect of endometriosis on implantation in women with endometriosis associated infertility
By Hale Goksever Celik
One of the most common clinical findings of women with endometriosis is fertility problems. Women with endometriosis often benefit from in vitro fertilization methods to get pregnant. However, whether there is a detrimental effect of endometriosis on in vitro fertilization outcomes…
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A rigorous literature review on endometriosis
By Irem Onur
Bulun SE. et al., from Feinberg School of Medicine, Northwestern University, Chicago, conducted a rigorous literature review on endometriosis. This outstanding review by Dr. Bulun et al. addresses the definition, remarkable medical features, clinically useful research findings, prevalence and distribution,…
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Increased obstetrical complications after ART therapy in endometriosis patients.
By Selma Oransay
To examine the impact of endometriosis and adenomyosis on ART therapy, Harada et al. from the Department of Obstetrics and Gynecology of Tottori University, Japan, planned a prospective cohort study and published their results recently in PLoS One. The study…
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Serum anti-Müllerian hormone levels for predicting spontaneous pregnancy after endometriosis surgery
By Hale Goksever Celik
Endometriosis is a disease defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. Although there are several medical and surgical therapeutic options, the most effective treatment modality has not yet been elucidated. The main…
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Infertility in women with endometriosis
By Hale Goksever Celik
Endometriosis is an estrogen-dependent gynecological disease mostly encountered in reproductive-aged women. The most common presenting complaints are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Despite extensive research, the etiopathogenic mechanism underlying the two has not been fully elucidated. Although human…
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Babies Born Lighter May Have a Higher Risk of Developing Endometriosis Later in Life
By Özge Özkaya
Being exposed to growth restriction before birth seems to be associated with a higher risk of developing endometriosis during a woman’s reproductive years. Other factors such as having fewer liveborn children and prior infertility problems, also seem to be important…
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The predictors for the coexistence of uterine leiomyomas and endometriosis
By Hale Goksever Celik
Uterine leiomyomas are the most common gynecological benign tumors affecting 20-25% of reproductive-aged women. Abnormal bleeding, pelvic pain, pelvic pressure, and infertility are major symptoms of these tumors. Endometriosis is another gynecological disease encountered in 10-15% of reproductive-aged women. The…
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Does Endometriosis Reduce Ovarian Reserve?
By Özge Özkaya
Markers of ovarian reserve are worse in infertile women with endometriosis compared to women who cannot conceive due to male factor infertility regardless of whether or not they have had ovarian surgery. This finding is important because it suggests that…
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Plasma Energy for Ovarian Endometriomas
By Timur Seckin
There are many different approaches used in the management of ovarian endometriomas such as stripping cystectomy, ablation, including electrical/thermal and CO2 laser ablation, fenestration/aspiration, and combined techniques. Plasma energy is a new promising treatment option for ovarian endometrioma and may be…
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Proposed algorithm for a clinical diagnosis of endometriosis.
By Selma Oransay
This recently published article in the American Journal of Obstetrics and Gynecology is about the challenge of diagnosing endometriosis, its impact on women's daily life and authored by Agarwal et al. from The University of California, San Diego, CA, USA. Authors called attention…
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Impact of Endometriosis-Related Adhesions on Quality of Life among Infertile Women
By Dr. Youngran Park
Endometriosis is considered the most common cause of pelvic adhesions in women. It is considered one of the main underlying causes of the development of adhesions. Adhesions are bands of connective tissue, which connect two different tissues that are normally…
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Endometriosis involving the superficial peritoneum in Adolescents: Surgical Management
By Murat Osman
Endometriosis is a chronic disease whereby endometrial glands and stroma grow and survive outside of the uterus. In some cases, endometriosis may become symptomatic and cause debilitating, chronic pelvic pain. Among pelvic organ and other surfaces that endometriosis can involve…
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Polymorphisms of STAT4 gene in the pathogenesis of endometriosis
By Dr. Youngran Park
Endometriosis is one of the most common gynecological diseases in reproductive-age women characterized by the occurrence of endometrial tissue outside the uterine cavity. Researchers have put forward numerous hypotheses to explain ectopic endometrial tissue, and the bulk of the evidence…
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Endometriosis and infertility: current concepts
By Nasuhi Engin Aydin
Hungarian and US scientists have published a comprehensive review on infertility related to endometriosis in Frontiers in Endocrinology, November 2018 issue. Endometriosis is a common entity in women of reproductive age which often leads to infertility. Compiled research data reveal…
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Which comes first in endometriosis management: In vitro fertilization or surgery?
By Hale Goksever Celik
Endometriosis is defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. The prevalence is found to be 7%–10%, but among infertile women, it increases up to 50%. Early diagnosis and personalized management are important to…
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Endometrioma, Fertility, and Assisted Reproduction
By Dr. Youngran Park
Endometriosis can negatively impact a woman’s health and quality of life. Surgery has been considered the primary treatment to overcome infertility in cases of ovarian endometrioma. Patients struggling with endometriosis often pursue assisted reproductive technologies (ART) due to fertility issues.…
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The association between the development of endometriosis and dietary habits
By Hale Goksever Celik
Endometriosis is a chronic disease defined as the localization of endometrial glandular and stromal tissue outside the uterine cavity. The prevalence is found to be approximately 10% in the general population. Endometriosis is associated with infertility, pelvic pain, and increased…
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By Demet Candaş GreenHOXA-10 levels are related to infertility in endometriosis patients
By Demet Candaş Green
The current study by Ozcan et al., published in the European Journal of Obstetrics & Gynecology and Reproductive Biology aimed to investigate the levels of HOXA-10 gene in fertile versus infertile women with endometriosis. HOXA-10 protein (expressed by HOXA-10 gene)…
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Not True That Women With Endometriosis Can’t Conceive
By Özge Özkaya
The common assertion that women with endometriosis are unlikely to conceive is countered by a new study published in The European Journal of Contraception & Reproductive Health Care. This finding supports the need for healthcare and information to address all…
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How to predict natural conception in women underwent endometriosis surgery?
By Hale Goksever Celik
Endometriosis is defined as the localization of endometrial glandular and stromal cells outside the uterine cavity. The most common symptoms are dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. The prevalence of endometriosis increases in the infertile population. Thus, the important…
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The diagnosis and management of endometriosis in Korea
By Selma Oransay
The Korean Society of Endometriosis has scrutinized the present published literature of endometriosis in the domestic and international platform to provide new guidelines and the clinical management of the disease. The study was recently published in the journal "Obstetrics and Gynecology…
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How Ovarian Endometriomas and DIE affect ART outcomes
By Murat Osman
Previous studies have evaluated the impact of an ovarian endometrioma on ovarian reserve and its impact on the success of assisted reproductive technology (ART) outcomes have controversial results. ART is a method by which a woman’s own hormones are used…
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Could Endometriosis-Related Infertility Be Genetic?
By Özge Özkaya
Researchers identified genetic polymorphisms or individual differences in two genes called AMA5 and KAZN among women with endometriosis who were infertile and control women who were fertile. The identification of these polymorphisms could help scientists better understand why some women…
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Non-assisted reproductive technology treatment: Is it effective in infertile patients with advanced endometriosis?
By Hale Goksever Celik
The marriage and childbearing ages delay due to the life-style changes in developed countries. As a result, advanced age becomes a major concern in infertility treatments which consist of non-ART and ART modalities. Non-ART treatments include mild ovarian stimulation together…
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Vitamin D and Endometriosis
By Nasuhi Engin Aydin
Scientists from Milan, Italy reviewed the effects of vitamin D on the reproductive health, and in particular "endometriosis" in their article which appeared in International Journal of Molecular Sciences. Vitamin D (VD), is a steroid hormone that is activated in…
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Laparoscopic surgery of endometriosis through three compartments
By Selma Oransay
This case study which is published in the J. of Minimally İnvasive Gynecology is the video demonstration of Collin et al who performed the laparoscopic operation of their patient in Gynecologic Surgery Department of Strasburg Hospital University, France. 37 years old…
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How to preserve fertility in women with “ovarian endometriosis”?
By Hale Goksever Celik
Although there are many treatment modalities in endometriosis, optimal treatment has not been developed yet. The aim of the treatment is to reduce pain, to preserve and improve fertility and to delay recurrence. Ovarian ischemic and perfusion damage during endometriosis…
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By Deniz KocasShedding light on the fertility preservation debate in women with endometriosis: a swot analysis.
By Deniz Kocas
There is little known about fertility preservation in women with endometriosis. Researchers from France and Switzerland conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis to better understand this topic. Applied to clinical problems, SWOT gives a thorough analysis of…
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Cosmetics and some household products could be responsible for worsening endometriosis.
By Selma Oransay
A controlled clinical study recently published in the Journal of Human Reproductive Sciences, composed by Nazir et al. from the University of Health Sciences, Lahore, Pakistan. The study compared the blood diethyl hexyl phthalate (DEHP) levels of fifty infertile women laparoscopically diagnosed…
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Toxic Pelvic Cavity and Infertility
By Murat Osman
Endometriosis is a disease defined by the presence of endometrial tissue outside of the uterine cavity and has an incidence of approximately 10% in women of reproductive age. Thus, it is an important consideration in chronic pelvic pain and infertility…
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Reduced pain and increased fertiliy rates after surgery for colorectal endometriosis
By Selma Oransay
This prospective cohort study which recently published in AOGS by Hudelist et al. from Oslo University, Norway is about their one hundred thirty-four laparoscopic operations of DIE cases performed between 2011 and 2016, in a tertiary center in Oslo. The…
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IVF Is the Best Option to Become Pregnant for Women with Severe Endometriosis, or Is It Not?
By Özge Özkaya
Treating rectal endometriosis with surgery seems to increase the chance of a woman conceiving, with most pregnancies occurring naturally. This is according to a study published in the medical journal Human Reproduction. The optimal treatment for women with severe endometriosis…
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How to evaluate ureteral endometriosis : A review of the literature
By Selma Oransay
In this recently published review of the literature, Barra et al. from Genova, Italy intend to provide a useful tool to guide physicians in the management of deep infiltrating endometriosis. Authors elected 67 abstracts from Pubmed and Medline in accordance with PRISMA…
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Should I Have Surgery Before Trying to Conceive?
By Özge Özkaya
The presence of rectouterine nodules is associated with a lower chance of becoming pregnant with in vitro fertilization (IVF), according to a study published in the Journal of Gynecology Obstetrics and Human Reproduction. This finding is important as it can…
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Vitamin C supplementation in the patients with endometriosis undergoing in vitro fertilization-embryo transfer
By Hale Goksever Celik
Endometriosis is defined as the localization of endometrial stromal and glandular cells outside the uterine cavity. Women having endometriosis present with dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Thus, infertility remains a significant problem for women with endometriosis. Endometriosis is…
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By Kasthuri NairGnRH Analogues Not Beneficial For Superovulation and Intrauterine Insemination
By Kasthuri Nair
Bansal et al, a group of authors from the All India Institute of Medical Sciences, recently published a paper titled “The Role of GnRH Analogues in Improving Outcome in Women Undergoing Superovulation and Intrauterine Insemination after Surgical Correction of Mild…
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Health-related quality of life in women with Endometriosis and Rheumatoid Arthritis
By Murat Osman
Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Unfortunately, endometriosis continues to be a leading cause of chronic pelvic pain and long-term morbidity in women of reproductive age.…
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Detecting endometriosis using peripheral blood
By Yu Yu
Laparoscopic visualization of endometriotic lesions with histological confirmation is the gold standard for the diagnosis of endometriosis. However, this diagnostic procedure, due to the need for laparoscopy and variability of disease/symptoms, can have a major delay up to 8-10 years…
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Is there a definitive guideline for the surgical management of endometriosis?
By Murat Osman
Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Unfortunately, endometriosis continues to be a leading cause of chronic pelvic pain in women of reproductive age. This article titled,…
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Predictors of psychological distress
By Deniz Kocas
Studies have now established that endometriosis can negatively impact mental health and quality of life, however, some studies show that not all women with endometriosis are necessarily more distressed than healthy women. This suggests that individual differences may explain women’s’…
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Difficulties Associated with Diagnosing Ascites and Encapsulating Peritonitis in Endometriosis
By Kasthuri Nair
De Magalhães et al. recently published a paper titled “Ascites and Encapsulating Peritonitis in Endometriosis: a Systematic Review with a Case Report” in Revista Brasileira de Ginecologia e Obstetrícia. The team from the Universidade Federal do Ceará and the Universidade…
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Is the Endometriosis Fertility Index Reliable?
By Kasthuri Nair
Zhang et al. recently published a paper titled “Prediction of Endometriosis Fertility Index in patients with endometriosis-associated infertility after laparoscopic treatment” in Reproductive BioMedicine Online. The research group from the West China Second University Hospital in Sichuan University wanted to…
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Extending the Female Fertility Clock
By Kasthuri Nair
Varela, Sanchez-de-Puerta, and Garcia-Velasco are a group of scientists from various institutions in Spain and they recently published a review article titled “Fertility, IVF and reproductive genetics” in Current Opinion in Obstetrics and Gynecology. In this publication, the authors discussed…
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Endometriosis surgery and preservation of fertility, what surgeons should know
By Murat Osman
Endometriosis can involve most of the pelvic organs including the uterus, ovaries and fallopian tubes and thus has the potential to cause infertility. This article titled, “Endometriosis surgery and preservation of fertility, what surgeons should know” written by H. Roman…
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Most Effective Embryo Transfer Strategy
By Kasthuri Nair
Bourdon et al., a group of scientists mainly from the Centre Hospitalier Universitaire, recently published a paper in PLOS ONE titled “The deferred embryo transfer strategy improves cumulative pregnancy rates in endometriosis-related infertility: A retrospective matched cohort study.” This study…
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Reproductive delay and social egg freezing
By Yu Yu
The data collected from Office for National Statistics in England and Wales has suggested a major shift in the timing of motherhood. In the mid-1970s, the average age of motherhood was 26.4 years of age to, while in 2016, it…
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Endometriosis From an Epigenetic Lens
By Kasthuri Nair
Samadieh et al. from the Royan Institute for Reproductive Biomedicine, recently published an article in Reproductive Sciences titled “Epigenetic Dynamics of HOXA10 Gene in Infertile Women With Endometriosis.” In this paper, the researchers wanted to observe HOXA10 gene expression in…
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Using the "Mushroom Cap" sign to describe endometriotic masses
By Murat Osman
Endometriosis is a disease whereby ectopic endometrial cells attach and grow outside of the uterus. A number of imaging techniques have been used to evaluate and assess endometriotic lesions. Magnetic resonance imaging (MRI) is a type of imaging modality used…
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Endocrine and inflammatory factors in current understanding of endometriosis
By Yu Yu
There are three forms of endometriosis: peritoneal, ovarian, and deep infiltrating. All three forms consist of endometriotic lesions containing endometrial glands, stroma, nerves, blood vessels, and inflammatory cells. Endometriosis symptoms can be accounted by these elements and the involving organs.…
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Endometrial stem cells and Endometriosis
By Dr. Youngran Park
Human endometrium is a cyclically proliferative tissue, and this monthly regeneration is likely mediated by endometrial stem (or progenitor) cells.The upper functional layer of the endometrium breaks down and is shed into the uterine cavity during menstruation. Re-epithelialization and repair…
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Endometriosis can Adversely Affect Oocyte Quality
By Kasthuri Nair
Kasapoglu et al. recently published a study in Gynecological Endocrinology titled “Detrimental effects of endometriosis on oocyte morphology in intracytoplasmic sperm injection cycles: a retrospective cohort study.” In this paper, they compared the oocytes recovered from women who have endometriosis…
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The Chance of Getting Pregnant of a Woman with Endometriosis May Soon Be Predictable
By Özge Özkaya
Researchers have found a new way of predicting whether or not an embryo will be able to successfully implant into the womb of a woman with endometriosis. These findings could make it possible to predict whether she is likely to…
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A How-To Guide for Endometriosis Surgery
By Kasthuri Nair
The European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) recently published a document titled “Recommendations for the surgical treatment of endometriosis—part 1: ovarian endometriomas.” This publication provides surgeons with recommendations for the technical aspects of…
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Does Endometriosis Cause Infertility?
By Özge Özkaya
Infertility may be related to the localization of endometriosis involvement according to a study published in the Journal of Obstetrics and Gynaecology. This finding is in agreement with the results of previous studies and could help clinicians in their decision…
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Another Marker to Predict the Outcome of IVF for Women with Endometriosis
By Özge Özkaya
AOPPs or advanced oxidative protein products may be new markers to predict egg quality and the outcomes of IVF in infertile women with endometriosis according to a study published in the journal Experimental and Therapeutic Medicine. This finding suggests that anti-oxidative treatments…
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The Past, Present, and Future of Diagnosing Endometriosis
By Kasthuri Nair
This review titled “Endometriosis: Epidemiology, Diagnosis and Clinical Management” published in Current Obstetrics and Gynecology Reports examines the distribution and factors associated with endometriosis. The analysis by Parasar, Ozcan, and Terry also delineates potential biomarkers and risk factors that could…
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Can Getting Pregnant Make my Pain Go Away?
By Özge Özkaya
The association between pregnancy and symptoms of endometriosis are controversial and strongly biased, and there is no evidence suggesting that pregnancy reduces the size and number of endometriotic lesions, according to a study published in the journal Human Reproduction Update.…
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Elevated Neutrophil Traps in Deep Infiltrating Endometriosis
By Yu Yu
Neutrophils are a part of the innate immune system and act as a first-line host defense system by phagocytosis, intracellular killing and more recently describes mechanism involving extracellular killing by means of neutrophil extracellular traps (NETs). These traps are defined…
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Which cell defines endometriosis?
By Murat Osman
A well-accepted theory regarding the pathogenesis of endometriosis hypothesizes that the origin of endometriosis is from peritoneal dissemination of endometrial cells and stroma during the neonatal period or menarche. Varying cellular components of endometriosis have been observed in the setting…
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Intestinal Endometriosis and Colorectal Cancer versus T4 Colorectal Cancer
By Kasthuri Nair
Ishii et al. recently published a paper titled “Intestinal endometriosis combined with colorectal cancer: a case series” in the Journal of Medical Case Reports. This case report follows 7 Japanese women who have intestinal endometriosis and colorectal cancer. These women…
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Endometriosis Not a Risk for Pregnancy
By Özge Özkaya
Women with endometriosis do not seem to be more at risk of having pregnancy-related complications compared to those without endometriosis, according to a study published in the Italian scientific journal Minerva Ginecologica. However, the authors say that larger studies are…
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Should Women with Endometriosis have IVF Treatment to Conceive Following Laparoscopic Surgery?
By Özge Özkaya
Women affected by endometriosis-associated infertility who are younger than 35, and have a good ovarian reserve and a partner with normal semen parameters can benefit from a so-called integrated approach for the management of their infertility, according to a study published…
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Centralization of Pelvic Endometriosis Care
By Kasthuri Nair
Dr. Patrick Chien, the Deputy Editor-in-Chief of BJOG, recently wrote an article titled “Pelvic endometriosis: will centralization of services improve patient care?” In this article, Dr. Chien formulated an opinion on the centralization of pelvic endometriosis care based on the…
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Changes in Complement Proteins Affect Infertility in Women with Endometriosis
By Kasthuri Nair
Palomino et al. recently published a paper titled “The endometria of women with endometriosis exhibit dysfunctional expression of complement regulatory proteins during the mid-secretory phase” in the Journal of Reproductive Immunology where they look at the expression of CRPs during the menstrual cycle of…
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EFA Medical Conference 2017: "Fertility Preservation to BRCA Mutations" Presentation by Dr. Kutluk Oktay
By Kasthuri Nair
Dr. Kutluk Oktay is the Director of the Laboratory of Molecular Reproduction & Fertility Preservation as well as a Professor of OBGYN at Yale University School of Medicine. Dr. Oktay also presented at the EFA 2017 Medical Conference, and his…
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Surgical treatment is an excellent option for women with endometriosis and infertility.
By Murat Osman
Women with endometriosis most often have difficulty becoming pregnant and thus require a combination of endometriosis treatment and infertility techniques to achieve pregnancy. Depending on the severity of endometriotic symptoms, women may or may not need surgical excision of endometriosis…
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EFA Medical Conference 2017: "Breast Cancer in Young Women; Early Diagnosis Timely Intervention" Presentation by Dr. Stephanie Bernik
By Kasthuri Nair
Dr. Stephanie Bernik is the Chief of Surgical Oncology of Surgery and General Surgery at the Lenox Hill Hospital. She recently presented at the EFA 2017 Medical Conference, and her presentation was titled “Breast Cancer in Young Women; Early Diagnosis…
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Treatment of minimal endometriosis in infertile women
By Demet Candaş Green
For women with mild/minimal endometriosis, European Society of Human Reproduction and Embryology (ESHRE) recommends the removal of endometriotic lesions to improve fertility and increase pregnancy rates. For women undergoing assisted reproductive treatment, there is ongoing debate whether surgical removal of…
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EFA.MC.2017.“The Abnormal Embryos That Aren’t”,“Tens of thousands of women thought they couldn't have babies: But what if they could.”Dr. Norbert Gleicher Dr. Monica Halem
By Özge Özkaya
The presentation started with the story of Monica Halem who had endometriosis and had been trying to conceive using in vitro fertilization VF), but was told that none of her fertilized embryos would be viable based on pre-implantation genetic screening…
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Women with Mild Endometriosis May Have a Higher Risk of Miscarriage
By Özge Özkaya
Mild endometriosis presents an increased risk of miscarriage according to a new study published in the scientific journal Fertility and Sterility. Researchers think that this may be because superficial lesions are associated with a greater extent of the inflammatory disorder, which may lead…
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Role of immune cells in endometriosis
By Demet Candaş Green
Immune cells have essential functions in the body such as detection and clearance of abnormal cells and debris. One of the possible mechanisms for the development of endometriosis is proposed to be the impaired function of immune system cells in…
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Is operation the best option for infertile patients with digestive endometriosis?
By Demet Candaş Green
A severe form of endometriosis affecting 8-12% of women with deep endometriosis is bowel endometriosis. Bowel involvement with associated infertility is a serious challenge for gynecologists who must choose between two main therapeutic options: surgery or medically assisted procreation (e.g.…
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Swimming Against the Stream: Is Surgery Worthwhile in Women with Deep Infiltrating Endometriosis and Pregnancy Intention?
By Murat Osman
Management of Deeply Infiltrating Endometriosis (DIE) is further complicated by the implications of affected patients who plan to become or are pregnant. Optimal management in this situation is not standardized due to a lack of randomized trials comparing primary surgery…
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The Endometriosis Fertility index Could Help Better Predict the Chance of Conceiving After Laparoscopy
By Özge Özkaya
The endometriosis fertility index (EFI) can more reliably predict the chance of a woman getting pregnant following endometriosis surgery compared to the revised-American Society of Reproductive Medicine score, according to a study published in the scientific journal Gynecologic and Obstetric…
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Ovarian Reserve Depletion is not Time Sensitive
By Kasthuri Nair
The European Journal of Obstetrics & Gynecology and Reproductive Biology recently published a paper titled “Is endometrioma-associated damage to ovarian reserve progressive? Insights from IVF cycles.” This publication by Benaglia et al. examines the controversial relationship between endometriosis and ovarian…
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Single Nucleotide Polymorphisms Play a Role in Endometriosis Related Infertility
By Kasthuri Nair
In their paper titled “Endometriosis-associated infertility: GDF-9, AMH, AMHR2 genes polymorphisms,” De Conto et al. attempt to elucidate the mechanism that leads to endometriosis-related infertility. In short, the authors hypothesize that there is a connection between polymorphisms in the Growth…
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Serum AMH Levels Play an Important Role In Fertility Preservation
By Kasthuri Nair
One of the options available for women who suffer from endometriosis related infertility is cryopreservation. This option is only viable if the woman in question does not suffer from the low ovarian reserve. Garavaglia et al. suggest using pre-surgical serum…
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Endometriosis and Psychological Health: Butterflies from Deep Wounds
By Kasthuri Nair
Endometriosis is a grueling disease in every sense of the word; however, most of the discussions center on the physical manifestations of the disease. Facchin et al. veer from the beaten path and examine the impact endometriosis have on a…
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Updates in the Field of Endometriosis: Surgery
By Kasthuri Nair
Surgery is one of the treatment options offered for individuals with endometriosis. With that in mind, there are a variety of surgical procedures that can be offered to an individual with endometriosis. In the chapter titled “Surgery and Endometriosis,” Zanelotti…
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Updates in the Field of Endometriosis: Fertility
By Kasthuri Nair
Infertility can be a significant problem for many women who are suffering from endometriosis. In their chapter titled “Endometriosis and Fertility,” Evans and Decherney discuss the role of endometriosis in infertility and examine the usefulness of various fertility treatments. The…
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Updates in the Field of Endometriosis: Fertility Preservation
By Kasthuri Nair
“Endometriosis and Fertility” is a chapter dedicated to examining the role of endometriosis and endometriomas in decreasing fertility. In other words, the authors of this chapter discuss the relationship between endometriomas, surgeries, and infertility. Barnett, Banks and Decherney also deliberate…
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Updates in the Field of Endometriosis
By Kasthuri Nair
A lot of progress has been made thus far in the field of endometriosis. Research has discovered various genetic and epigenetic components involved in endometriosis. There has also been a progression in the diagnosis and treatment of the disease since…
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Endometriosis Fertility Index Anticipates Pregnancy in Women with Endometriosis
By Kasthuri Nair
Women are often afflicted by endometriosis during their reproductive years and can be faced with the prospect of infertility. These women also undergo treatments and procedures that can further affect their fertility. Consequently, in 2010, Adamson and Pasta came up…
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Best Time for IVF Between 7 and 25 Months Post Surgery Study Suggests
By Özge Özkaya
The more severe endometriosis is, the lower the success rate of IVF, according to a new study published in the Journal of Minimally Invasive Gynecology. However, the presence of endometriosis as such does not seem to affect the outcome of…
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A Systematic Review of Guidelines for Diagnosis and Management of Endometriosis
By Yu Yu
Guidelines are systematically developed statements derived from best research evidence to improve patient care through informed clinical practice. Appropriate guidelines can reduce unwarranted variations health practice and the implementation of better interventions. Endometriosis commonly has three different manifestations, including peritoneal…
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First-line surgery followed by ART versus ART alone among women with colon-involving endometriosis.
By Murat Osman
Endometriosis, a disease characterized by the presence of endometrial tissue outside the uterus, may cause pelvic and gynecologic complications that affect fertility in women of reproductive age. Several forms of endometriosis have been observed that are characterized by the varying…
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Cystectomy More Likely to Cause Infertility than Laparoscopic Vaporization
By Özge Özkaya
Treating patients with endometriotic ovarian cysts using laparoscopic vaporization may be better than treating them with cystectomy, or the surgical removal of cysts, regarding fertility. This information is according to a study conducted by Japanese scientists and published in the Asian…
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Women with Deep Infiltrating Endometriosis Have a Higher Risk of Appendix Involvement
By Özge Özkaya
Women with deep-infiltrating endometriosis, a form of endometriosis that invades the abdominal and pelvic cavity, have an increased risk of developing endometriosis of the appendix. It is therefore important to check women with deep infiltrating endometriosis for appendix involvement during…
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Endometrial Receptivity and Infertility
By Kasthuri Nair
A study entitled “Endometrial receptivity in eutopic endometrium in patients with endometriosis: it is not affected, and let me show you why” was recently published in Fertility and Sterility explored the relationship between endometriosis and infertility. This study conducted by Miravet-Valenciano et al.…
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ICSI Outcomes for Laparoscopic Intervention of Endometriosis
By Kasthuri Nair
Women with endometriosis can have trouble conceiving and often turn to fertility treatments for help. Guler et al. recently published a paper in Systems Biology in Reproductive Medicine titled “The Impact of laparoscopic surgery of peritoneal endometriosis and endometrioma on…
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Novel Biological Pathway Could Offer new Treatment Option for Endometriosis
By Özge Özkaya
Researchers have identified a novel biological pathway that may be involved in endometriosis. Targeting this pathway may, therefore, be a new alternative approach to treating the condition in the future. Endometriosis is characterized by the tissue that normally lines the…
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How ERα is regulated in endometriosis?
By Yu Yu
Endometriosis pathogenesis is largely influenced by estrogen. Ectopic endometrium has altered expression of ERα compared to the eutopic endometrium. It is unclear what biological processes regulate such alteration. The article by Toderow et al. in Archives of Gynecology and Obstetrics…
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Pregnancy Risks Associated with Severe Endometriosis
By Kasthuri Nair
Living with endometriosis can be painful and challenging; however, the challenges increase for women that are pregnant and have this disease. Recently, BJOG published an article titled “The ominous association between severe endometriosis, in-vitro fertilization, and placenta praevia: Raising awareness,…
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Deep Infiltrating Endometriosis, Surgery and Fertility
By Kasthuri Nair
Carneiro, Costa, and Ávila recently published an article in a scientific journal named Reproduction, titled “To operate or not to operate on women with deep infiltrating endometriosis (DIE) before in vitro fertilization (IVF),” that explored the relationship between DIE and infertility.…
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Endometriosis as a Barrier to Fertility
By Murat Osman
Some of the articles in the from the journal "Acta Obstetricia et Gynecologica Scandinavica (AOGS) issue are discussed in further detail below: Pain caused by endometriosis has been seen to significantly impact women's physical, psychosocial, and sexual health. Although endometriosis has been…
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Immune substances in peritoneal fluid for endometriosis diagnosis and armamentarium
By Yu Yu
Cytokines are immune substances secreted by a broad range of cells within the body, including immune cells like the macrophages, B lymphocytes, T lymphocytes, mast cells, and non-immune cells such as the endothelial cells and fibroblasts. They are important in…
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