ESHRE guideline: endometriosis

Human Reproduction Open, Год журнала: 2022, Номер 2022(2)

Опубликована: Янв. 1, 2022

How should endometriosis be diagnosed and managed based on the best available evidence from published literature?The current guideline provides 109 recommendations diagnosis, treatments for pain infertility, management of disease recurrence, asymptomatic or extrapelvic disease, in adolescents postmenopausal women, prevention association with cancer.Endometriosis is a chronic condition plethora presentations terms not only occurrence lesions, but also presence signs symptoms. The most important symptoms include infertility.The was developed according to structured methodology development ESHRE guidelines. After formulation key questions by group experts, literature searches assessments were performed. Papers up 1 December 2020 written English included review.Based collected evidence, formulated discussed within specialist subgroups then presented core (GDG) until consensus reached. A stakeholder review organized after finalization draft. final version approved GDG Executive Committee.This aims help clinicians apply care women endometriosis. Although studies mostly focus reproductive age, addresses women. outlines diagnostic process endometriosis, which challenges laparoscopy histology as gold standard tests. options treatment endometriosis-associated analgesics, medical surgery. Non-pharmacological are discussed. For surgical and/or medically assisted reproduction feasible. While more recent confirm previous recommendations, there five topics significant changes required clinical practice expected.The describes different but, existing no firm could appropriate treatments. Also, specific issues, such too scarce make evidence-based recommendations.The clear advice care, currently available. In addition, list research provided stimulate further endometriosis.The funded ESHRE, covering expenses associated meetings, dissemination guideline. members did receive payments. C.M.B. reports grants Bayer Healthcare European Commission; Participation Data Safety Monitoring Board Advisory ObsEva (Data Group) Myovant (Scientific Group). A.B. FEMaLE executive board member Commission Horizon grant; consulting fees Ethicon Endo Surgery, Medtronic; honoraria lectures Ethicon; support meeting attendance Gedeon Richter; A.H. MRC, NIHR, CSO, Roche Diagnostics, Astra Zeneca, Ferring; Consulting Nordic Pharma, Chugai Benevolent Al Bio Limited all paid institution; pending patent Serum biomarker; he Chair TSC STOP-OHSS CERM trials. O.H. speaker's Richter AG; attending meetings Gedeon-Richter, leadership roles at Finnish Society Obstetrics Gynecology federation societies obstetrics gynecology. L.K. Richter, AstraZeneca, Novartis, Dr KADE/Besins, Palleos Healthcare, Roche, Mithra; has role German Gynecological Endocrinology (DGGEF). M.K. French Foundation Medical Research (FRM), Australian Ministry Health, Future Fund National Cancer Institute; Gynaecological Endoscopy (ESGE), Congress Endometriosis (EEC) ESHRE; She an advisory Member, FEMaLe Project (Finding Using Machine Learning), Scientific Committee ComPaRe-Endometriosis cohort. A.N. Merck SA speaker SA; Pharma she board, Society, Netherlands (patients advocacy group) World Society. E.S. Institute Health UK, Rosetrees Trust, Barts London Charity; Royalties De Gruyter (book editor); Hologic; speakers Hologic, Johnson & Johnson, Medtronic, Intuitive, Olympus Karl Storz; Medicines Women's Expert Group Products Regulatory Agency (MHRA); Ambassador C.T. SA, Ferring, SA. other authors have conflicts interest declare.This represents views achieved careful consideration scientific time preparation. absence certain aspects, between relevant stakeholders been obtained. Adherence these guidelines does guarantee successful outcome, nor it establish care. Clinical do replace need application judgement each individual presentation, variations locality facility type. makes warranty, express implied, regarding specifically excludes any warranties merchantability fitness particular use purpose (Full disclaimer www.eshre.eu/guidelines.).

Язык: Английский

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Endometriosis: Etiology, pathobiology, and therapeutic prospects

Cell, Год журнала: 2021, Номер 184(11), С. 2807 - 2824

Опубликована: Май 1, 2021

Язык: Английский

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Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature)

International Journal of Molecular Sciences, Год журнала: 2021, Номер 22(19), С. 10554 - 10554

Опубликована: Сен. 29, 2021

Endometriosis is a “mysterious” disease and its exact cause has not yet been established. Among the etiological factors, congenital, environmental, epigenetic, autoimmune allergic factors are listed. It believed that primary mechanism of formation endometriosis foci retrograde menstruation, i.e., passage menstrual blood through fallopian tubes into peritoneal cavity implantation exfoliated endometrial cells. However, since this also observed in healthy women, other must be involved foci. many women infertility, chronic pain deterioration quality life. represents significant financial burden on health systems. The article presents review literature endometriosis—a affecting throughout world.

Язык: Английский

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Pathophysiology, diagnosis, and management of endometriosis

BMJ, Год журнала: 2022, Номер unknown, С. e070750 - e070750

Опубликована: Ноя. 14, 2022

Endometriosis affects approximately 190 million women and people assigned female at birth worldwide. It is a chronic, inflammatory, gynecologic disease marked by the presence of endometrial-like tissue outside uterus, which in many patients associated with debilitating painful symptoms. Patients endometriosis are also greater risk infertility, emergence fatigue, multisite pain, other comorbidities. Thus, best understood as condition variable presentation effects multiple life stages. A long diagnostic delay after symptom onset common, persistence recurrence symptoms despite treatment common. This review discusses potential genetic, hormonal, immunologic factors that lead to endometriosis, focus on current management strategies for gynecologists, general practitioners, clinicians specializing conditions higher risk. examines evidence supporting different surgical, pharmacologic, non-pharmacologic approaches treating presents an easy adopt step-by-step strategy. As multisystem disease, should ideally be offered personalized, multimodal, interdisciplinary approach. priority future discovery determining clinically informative sub-classifications predict prognosis enhance prioritization.

Язык: Английский

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Endometriosis and cancer: a systematic review and meta-analysis

Human Reproduction Update, Год журнала: 2020, Номер 27(2), С. 393 - 420

Опубликована: Авг. 26, 2020

Endometriosis is an often chronic, inflammatory gynaecologic condition affecting 190 million women worldwide. Studies have reported elevated cancer risk among patients with endometriosis. However, prior research has included methodologic issues that impede valid and robust interpretation.We conducted a meta-analysis of studies investigating the association between endometriosis analysed results by characteristics. We discuss implications screening in management challenges faced clinicians.We searched PubMed Embase databases for eligible from inception through 24 October 2019. cohort case-control examining risk; cross-sectional case reports were excluded. Publications had to present risk/rate/odds estimates 95% CI. Random effects was used estimate summary relative risks (SRR) CIs. Heterogeneity across assessed Q test I2 statistics, publication bias using Egger's Begg's tests. Risk quality non-randomized interventions (ROBINS-I) tool.Forty-nine population-based included. Twenty-six scored as having 'serious'/'critical' bias, remaining 23 'low'/'moderate'. Cancer-specific analyses showed positive ovarian (SRR = 1.93, CI 1.68-2.22; n studies) strongest clear cell 3.44, 2.82-4.42; 5 endometrioid 2.33, 1.82-2.98; histotypes (Pheterogeneity < 0.0001), although significant evidence both heterogeneity (Egger's P-values 0.01). A observed thyroid 1.39, =1.24-1.57; studies), very small breast 1.04, =1.00-1.09; 20 no colorectal 1.00, =0.87-1.16; studies). The endometrial not statistically 1.23, =0.97-1.57; 17 overall wholly null when restricted prospective 0.99, =0.72-1.37; cutaneous melanoma also non-significant 1.17, =0.97-1.41; 7 but increased magnitude low/moderate 1.71, 1.24-2.36, 2 most finding terms statistical significance effect inverse cervical 0.68, =0.56-0.82; 4 studies); however, this result high potential reflect heightened access detection dysplasia who reached diagnosis thus likely causal. Several additional types explored based on <4 studies.Endometriosis associated higher thyroid, minimally (only 4% greater risk) cancer, lower cancer. confirms that: majority severe/critical bias; there impactful studies-and causal inference requires temporality, which many considered. these associations perspectives endometriosis, clinicians involved their care, scientists long-term health risks.

Язык: Английский

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Prevalence and incidence of endometriosis in Australian women: a data linkage cohort study

BJOG An International Journal of Obstetrics & Gynaecology, Год журнала: 2020, Номер 128(4), С. 657 - 665

Опубликована: Авг. 5, 2020

Objective To estimate the prevalence and incidence of endometriosis among Australian women. Design Population‐based cohort study linked to administrative health records. Setting Secondary analysis seven surveys collected between 2000 2018 from a population‐based study. Population A total 13 508 women, born 1973–78, prospective 14 247 women conducted 1996 2018. Methods During 2018, self‐reported longitudinal survey data were three databases separately identify with clinically confirmed or suspected across multiple sources. Main outcome measures Prevalence in first estimated using national hospital data. Data then combined other capture all diagnoses endometriosis. Results The cumulative was 6.0% (95% CI 5.8–6.2%) by age 40–44 years. increased 11.4% 11.1–11.7%) when adding Age‐specific estimates peaked 6 per 1000 person‐years at 30–34 Conclusions Among followed for 20 years, one nine had 44, most diagnosed during their early thirties. Endometriosis is significant public issue requiring surveillance, clinical awareness management. Efforts expand knowledge on aetiology disease optimal methods management are crucial women's health. Tweetable abstract In 44.

Язык: Английский

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Impacts of endocrine disrupting chemicals on reproduction in wildlife and humans

Environmental Research, Год журнала: 2021, Номер 208, С. 112584 - 112584

Опубликована: Дек. 21, 2021

Endocrine disrupting chemicals (EDCs) are ubiquitous in aquatic and terrestrial environments. The main objective of this review was to summarize the current knowledge impacts EDCs on reproductive success wildlife humans. examples selected often include a retrospective assessment over time discern how effects have changed last several decades. Collectively, evidence summarized here within reinforce concept that reproduction humans is negatively impacted by anthropogenic chemicals, with altering endocrine system function. These observations interfering different aspects axis particularly pronounced for species corroborated laboratory-based experiments (i.e. fish, amphibians, birds). Noteworthy, many these same indicators also observed epidemiological studies mammalian Given vast array strategies used animals, it perhaps not surprising no single disrupted target predictive effects. Nevertheless, there some general features control reproduction, particular, critical role steroid hormones play processes confer high degree susceptibility environmental chemicals. New research needed implications chemical exposures during development potential long-term Future emphasis field-based can form basis more deliberate, extensive, population level monitor contaminant effects, including adverse system, key addressing gaps.

Язык: Английский

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The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions

Nature Genetics, Год журнала: 2023, Номер 55(3), С. 423 - 436

Опубликована: Март 1, 2023

Язык: Английский

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Diagnosis and management of endometriosis

Canadian Medical Association Journal, Год журнала: 2023, Номер 195(10), С. E363 - E371

Опубликована: Март 13, 2023

[For a first-person account of endometriosis, see www.cmaj.ca/lookup/doi/10.1503/cmaj.230215][1] KEY POINTS Endometriosis is chronic condition defined by the presence endometrial-like tissue outside uterus, which can lead to estrogen-driven inflammation. The extent disease be

Язык: Английский

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Intricate Connections between the Microbiota and Endometriosis

International Journal of Molecular Sciences, Год журнала: 2021, Номер 22(11), С. 5644 - 5644

Опубликована: Май 26, 2021

Imbalances in gut and reproductive tract microbiota composition, known as dysbiosis, disrupt normal immune function, leading to the elevation of proinflammatory cytokines, compromised immunosurveillance altered cell profiles, all which may contribute pathogenesis endometriosis. Over time, this dysregulation can progress into a chronic state inflammation, creating an environment conducive increased adhesion angiogenesis, drive vicious cycle endometriosis onset progression. Recent studies have demonstrated both ability induce changes, antibiotics treat Endometriotic microbiotas been consistently associated with diminished Lactobacillus dominance, well elevated abundance bacterial vaginosis-related bacteria other opportunistic pathogens. Possible explanations for implications dysbiosis include Bacterial Contamination Theory activation, cytokine-impaired estrogen metabolism signaling, aberrant progenitor stem-cell homeostasis. Although preliminary, antibiotic probiotic treatments efficacy treating endometriosis, female (FRT) sampling has successfully predicted disease risk stage. Future research should aim characterize “core” upper FRT elucidate mechanisms behind relationship between

Язык: Английский

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