The effects of coagulation factors on the risk of endometriosis: a Mendelian randomization study

BMC Medicine, Journal Year: 2023, Volume and Issue: 21(1)

Published: May 25, 2023

Endometriosis is recognized as a complex gynecological disorder that can cause severe pain and infertility, affecting 6-10% of all reproductive-aged women. condition in which endometrial tissue, normally lines the inside uterus, deposits other tissues. The etiology pathogenesis endometriosis remain ambiguous. Despite debates, it generally agreed chronic inflammatory disease, patients with appear to be hypercoagulable state. coagulation system plays important roles hemostasis responses. Therefore, purpose this study use publicly available GWAS summary statistics examine causal relationship between factors risk endometriosis.To investigate endometriosis, two-sample Mendelian randomization (MR) analytic framework was used. A series quality control procedures were followed order select eligible instrumental variables strongly associated exposures (vWF, ADAMTS13, aPTT, FVIII, FXI, FVII, FX, ETP, PAI-1, protein C, plasmin). Two independent cohorts European ancestry used: UK Biobank (4354 cases 217,500 controls) FinnGen (8288 68,969 controls). We conducted MR analyses separately FinnGen, by meta-analysis. Cochran's Q test, MR-Egger intercept leave-one-out sensitivity used assess heterogeneities, horizontal pleiotropy, stabilities SNPs endometriosis.Our analysis 11 suggested reliable effect genetically predicted plasma ADAMTS13 level on decreased risk. negative positive vWF observed FinnGen. In meta-analysis, associations remained significant strong size. also identified potential effects different sub-phenotypes endometrioses.Our based data from large-scale population studies demonstrated ADAMTS13/vWF endometriosis. These findings suggest these are involved development may represent therapeutic targets for management disease.

Language: Английский

---

Endometriosis and autoimmunity

Autoimmunity Reviews, Journal Year: 2025, Volume and Issue: unknown, P. 103752 - 103752

Published: Jan. 1, 2025

Language: Английский

---

Cine-MRI for Quantifying Uterine Peristalsis: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(3), P. 1021 - 1021

Published: Feb. 6, 2025

Background: Uterine contractility, also known as uterine peristalsis (UP), is a critical determinant of fertility, affecting sperm transport and embryo implantation. Increased peristaltic activity has been associated with reduced pregnancy rates. However, data are heterogeneous contractility not widely translated into clinical practice. Cine-MRI, although limited by cost heterogeneity in reporting, emerged promising tool to assess dynamics increase our knowledge UP physiological pathological conditions. Objective: This systematic review meta-analysis aimed describe patterns conditions, including endometriosis fibroids, using cine-MRI. Methods: A literature search the Medline, Embase, Cochrane CENTRAL databases Google Scholar was conducted up May 2024, studies evaluating Clinical were included, excluding those affected therapeutic interventions or unrelated pathologies. pooled from comparing patients endometriosis. Results: In 13 included (365 women), varied significantly according menstrual cycle phases showed that women had higher luteal phase (0.74; 95% CI: 0.27–1.21) but periovulatory (SMD 0.8; −3.78–5.37). Conclusions: Cine-MRI diagnostic for analysis UP. Endometriosis impaired UP, which may be cause decreased implantation rate infertility further research needed consolidate effect on fertility develop standardised cost-effective tools tailor treatment.

Language: Английский

---

Linzagolix therapy versus a placebo in patients with endometriosis-associated pain: a prospective, randomized, double-blind, Phase 3 study (EDELWEISS 3)

Human Reproduction, Journal Year: 2024, Volume and Issue: 39(6), P. 1208 - 1221

Published: April 22, 2024

Abstract STUDY QUESTION Does linzagolix administered orally once daily for up to 3 months at a dose of 75 mg alone or 200 in combination with add-back therapy (ABT) (1.0 estradiol; 0.5 norethindrone acetate, also known as norethisterone acetate [NETA]) demonstrate better efficacy than placebo the management endometriosis-related dysmenorrhea and non-menstrual pelvic pain? SUMMARY ANSWER Combining ABT was found significantly reduce pain therapy, while yielded significant decrease only months. WHAT IS KNOWN ALREADY? A previously published Phase 2, dose-finding study reported that daily, promotes full suppression estradiol secretion serum levels below 20 pg/ml noted addition may be needed manage hypoestrogenic side effects. At lower doses (75 100 mg/day), maintains values within target range 20–60 pg/ml, which could ideal alleviate symptoms linked endometriosis. DESIGN, SIZE, DURATION EDELWEISS multicenter, prospective, randomized, placebo-controlled, double-blind, double-dummy evaluate safety treatment moderate-to-severe endometriosis-associated pain. Treatment 6 PARTICIPANTS/MATERIALS, SETTING, METHODS In trial, 486 subjects were randomized 1:1:1 ratio one three groups: placebo, association ABT. Pain measured on verbal rating scale recorded an electronic diary. MAIN RESULTS AND THE ROLE OF CHANCE months, met primary objective, showing clinically meaningful statistically reductions pain, stable decreased use analgesics. The proportion responders group 72.9% compared 23.5% (P < 0.001), rates 47.3% 30.9% = 0.007), respectively. demonstrated reduction versus 44.0% 0.001). Although showed trend toward relative it not 0.279). Significant improvements dyschezia overall observed both groups when placebo. Small dyspareunia scores but they significant. groups, effects mild, low hot flushes bone density loss <1%. therapy. LIMITATIONS, REASONS FOR CAUTION Efficacy between placebo; however, would useful have results from comparative studies estro-progestogens progestogens. It will important ascertain whether gonadotropin-releasing hormone antagonists benefits over traditional first-line medications. WIDER IMPLICATIONS FINDINGS Linzagolix quality life improved risks vasomotor minimized due suitable chronic without need concomitant hormonal ABT, further research is confirm this. If confirmed, offer viable option women who do want wish whom contraindicated. FUNDING/COMPETING INTEREST(S) Funding provided by ObsEva (Geneva, Switzerland). Analysis data manuscript writing partially supported Switzerland), Theramex (London, UK) Kissei (Japan) grant 5/4/150/5 awarded M.-M.D. FNRS. J.D. member scientific advisory board until August 2022, PregLem, received personal fees Gedeon Richter, Theramex. consulting fees, speakers’ travel support Obseva Theramex, paid their institution. C.B. has Myovant, Richter—all funds went University Oxford. He monitoring supervising current study, served endometriosis Myovant. H.T. grants Abbvie past president ASRM. F.C.H. Richter O.D. lectures clinical Preglem independent study. A.H. NIHR, UKRI, CSO, Wellbeing Women, Roche Diagnostics; he A.H.’s institution honoraria consultancy Diagnostics, Gesynta, Joii. M.P. nothing declare. F.P. S.P.R. been Richter. A.P. M.B. are employees E.B. employee ObsEva, sponsor chair working consultant since December 2022; she owns stock options ObsEva. TRIAL REGISTRATION NUMBER NCT 03992846. DATE June 2019. FIRST PATIENT’S ENROLLMENT 13

Language: Английский

---

The clinical efficacy and influencing factors of uterine artery embolization in the treatment of different types of uterine adenomyosis

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Feb. 19, 2025

Uterine adenomyosis, a common benign tumor disease in gynecology, mainly manifested as chronic pelvic pain, menstrual disorders, dysmenorrhea, etc., has great impact on patients' daily life and work. Compared with traditional surgery drug therapy, uterine artery embolization (UAE), new treatment less trauma, faster recovery preservation, can relieve pain while preserving normal physiological reproductive functions of the uterus, which is favored by majority patients. In this study, patients were divided into two groups based magnetic resonance imaging (MRI) test. Their serum CA125 level was detected, degree symptom relief health index evaluated, aiming to explore clinical efficacy influencing factors UAE adenomyosis. The results showed that before UAE, group B significantly higher than A, 2 days after both lower treatment, indicating may be related type but good therapeutic effect focal diffuse 3 months interventional had reduced symptoms dramatically improved status VAS score reduced, improve performed groups. No serious complications occurred during operation, technical success rate reached 100%. summary, minimally invasive obvious significant effects an important alternative for

Language: Английский

---

Management of women with endometriosis in the 21st century

Current Opinion in Obstetrics & Gynecology, Journal Year: 2025, Volume and Issue: unknown

Published: April 10, 2025

Purpose of review Endometriosis is a chronic inflammatory condition that significantly affects women’s quality life and fertility. Despite advancements in treatment, many areas uncertainty persist clinical management. This provides symptom-focused, patient-centered update, addressing cases from asymptomatic to those complicated by pain infertility Recent findings Advancement imaging technology has increased incidental diagnoses endometriosis, raising the debate between immediate treatment watchful waiting. Medical therapy primarily aims suppress symptoms, with oral gonadotropin-releasing hormone antagonists add-back offering promising long-term control. Research into local neurogenesis central sensitization supports complementary approaches, though high-quality evidence still limited. For refractory medical therapy, conservative surgical strategies can minimize postoperative complications without increasing recurrence rates. In infertility, assisted reproductive (ART) effective options, although optimal endometrial preparation necessity pre-ART surgery remain be fully elucidated Summary The management endometriosis requires personalized, multidisciplinary approach within specialized centers. Long-term suppressive remains cornerstone while emerging targeted agents hold promise for better symptom control fewer side effects. Surgical intervention should performed experienced surgeons as single definitive procedure when possible. Tailored ART protocols address challenges. Standardized classification systems robust randomized trials are crucial refining pathways, optimizing fertility outcomes, enhancing life.

Language: Английский

---

Endometrial receptivity in adenomyosis and/or endometriosis

Fertility and Sterility, Journal Year: 2023, Volume and Issue: 119(5), P. 741 - 745

Published: March 11, 2023

Language: Английский

---

Impact of adenomyosis on in vitro fertilization outcomes in women undergoing donor oocyte transfers: a prospective observational study

Fertility and Sterility, Journal Year: 2023, Volume and Issue: 121(3), P. 480 - 488

Published: Dec. 1, 2023

Language: Английский

---

Decreased oocyte quality in patients with endometriosis is closely related to abnormal granulosa cells

Frontiers in Endocrinology, Journal Year: 2023, Volume and Issue: 14

Published: Aug. 16, 2023

Infertility and menstrual abnormalities in endometriosis patients are frequently caused by aberrant follicular growth or a reduced ovarian reserve. Endometriosis typically does not directly harm the oocyte, but rather inhibits function of granulosa cells, resulting decrease oocyte quality. Granulosa as nanny can regulate meiosis, provide most basic resources required for development, influence ovulation. affects development quality causing cells apoptosis, inflammation, oxidative stress, steroid synthesis obstacle, mitochondrial energy metabolism. These states interact with one another, however there is currently relatively little research this field to understand mechanism linkage between abnormal states.

Language: Английский

---

Proposal for targeted, neo-evolutionary-oriented secondary prevention of early-onset endometriosis and adenomyosis. Part II: medical interventions

Human Reproduction, Journal Year: 2023, Volume and Issue: 39(1), P. 18 - 34

Published: Nov. 10, 2023

According to consistent epidemiological data, the slope of incidence curve endometriosis rises rapidly and sharply around age 25 years. The delay in diagnosis is generally reported be between 5 8 years adult women, but it appears over 10 adolescents. If this true, actual onset many young women would chronologically placed early postmenarchal Ovulation menstruation are inflammatory events that, when occurring repeatedly for years, may theoretically favour development adenomyosis. Moreover, repeated acute dysmenorrhoea episodes after menarche not only an indicator ensuing or adenomyosis, also promote transition from chronic pelvic pain through central sensitization mechanisms, as well overlapping conditions. Therefore, secondary prevention aimed at reducing suffering, limiting lesion progression, preserving future reproductive potential should focused on group that could benefit most intervention, i.e. severely symptomatic Early-onset adenomyosis promptly suspected even physical ultrasound findings negative, long-term ovulatory suppression established until conception seeking. As nowadays mean using hormonal therapies several drug safety evaluation crucial. In adolescents without recognized major contraindications oestrogens, use very low-dose combined oral contraceptives associated with a marginal increase individual absolute risk thromboembolic events. Oral containing oestradiol instead ethinyl further limit such risk. Oral, subcutaneous, intramuscular progestogens do risk, interfere attainment peak bone mass women. Levonorgestrel-releasing intra-uterine devices safe alternative adolescents, amenorrhoea frequently induced ovarian activity. With regard oncological net effect oestrogen-progestogen combinations small reduction overall cancer Whether surgery considered first-line approach symptoms seems questionable. Especially large endometriomas infiltrating lesions detected imaging, laparoscopy reserved who refuse treatments whom medications effective, tolerated, contraindicated. Diagnostic therapeutic algorithms, including self-reported outcome measures, individuals clinical suspicion early-onset proposed.

Language: Английский

---