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Evolving Spectrum:: The Pathogenesis of Endometriosis

JENSEN, JANI R. MD; CODDINGTON, CHARLES C. III MD

Clinical Obstetrics & Gynecology: June 2010 - Volume 53 - Issue 2 - pp 379-388
doi: 10.1097/GRF.0b013e3181db7b84
Endometriosis

Although the exact etiology of endometriosis is unknown, several hypotheses about its origin exist. Of these, Sampson's theory of retrograde menstruation is the most widely accepted. Multiple in-vitro and in vivo models have been developed to study endometriosis. Several key steps are required to establish an endometriotic implant: presence of ectopic endometrial glands and stroma, attachment of endometrial cells to the peritoneum, invasion into the mesothelium, and survival and growth of the ectopic tissue. Many of these steps are similar to those associated with neoplasia, and numerous biologic pathways are involved. It is likely that both intrinsic factors within the ectopic endometrium and permissive alterations within the host are important to the development of endometriosis.

Division of Reproductive Medicine, Mayo Clinic, Rochester, Minnesota

Correspondence: Charles C. Coddington, III, MD, Division of Reproductive Medicine, Mayo Clinic, 200 1st St. SW, Rochester, MN 55901. E-mail: Coddington.charles@mayo.edu

© 2010 Lippincott Williams & Wilkins, Inc.