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Clinical Perspectives on Adenomyosis- and Endometriosis-Associated Infertility

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 8541

Special Issue Editors


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Guest Editor
Department of Obstetrics and Gynecology, Cantonal Hospital of Schaffhausen, 8208 Schaffhausen, Switzerland
Interests: endometriosis; adenomyosis; infertility

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Guest Editor
1st Department of Obstetrics and Gynecology, Papageorgiou General Hospital, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
Interests: reproductive surgery; endometriosis

Special Issue Information

Dear Colleagues,

Endometriosis and adenomyosis are common benign gynecological disorders that affect reproductive-aged women. Both conditions share a histologic pattern, displaying the presence of ectopic endometrial tissue in unusual locations, and are associated with adverse reproductive outcomes. The heterogeneity of endometriosis and adenomyosis, as well as their frequent coexistence, contribute to the variability in available evidence. Proposed reasons for its association with adverse reproductive outcomes include disrupted pelvic anatomy, chronic pelvic inflammation, and reduced ovarian reserves for endometriosis, while uterine inflammation, abnormal contractility, and abnormal endothelial function are suggested to be causes of adenomyosis. Despite numerous studies being published in recent years, effective treatment strategies in infertile women with these conditions are still unclear, posing a common challenge during counseling of this population.

For this Special Issue, we invite our colleagues to submit work focused on relevant topics, such as the role of surgery in infertility based on different subtypes of endometriosis and adenomyosis, the hormonal pretreatment in assisted reproductive technology, fertility preservation, and other coexistent clinical entities associated with endometriosis and adenomyosis.

Dr. Dimitrios Rafail Kalaitzopoulos
Prof. Dr. Angelos Daniilidis
Guest Editors

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Keywords

  • endometriosis
  • adenomyosis
  • infertility
  • assisted reproductive technology
  • IVF
  • laparoscopy
  • hormonal therapy
  • reproductive outcomes

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Published Papers (3 papers)

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Review

13 pages, 826 KiB  
Review
Mechanisms of Endometrioma-Mediated Ovarian Damage: Myths and Facts
by Pınar Özcan, Bulut Varlı, Ertan Sarıdoğan, Engin Oral, Muhammed Mabrouk, Taner Usta and Alin Stefan Constantin
J. Clin. Med. 2025, 14(7), 2147; https://doi.org/10.3390/jcm14072147 - 21 Mar 2025
Viewed by 1351
Abstract
Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20–40% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively [...] Read more.
Ovarian endometriomas (OEMs), cystic formations within the ovaries, are a significant manifestation of endometriosis and present in 20–40% of affected women. Despite extensive research, the pathogenesis of endometriosis remains unclear, with retrograde menstruation, coelomic metaplasia, and lymphatic dissemination being proposed mechanisms. OEMs negatively impact ovarian function by reducing the ovarian reserve, disrupting folliculogenesis, and altering the ovarian microenvironment through oxidative stress, inflammation, and fibrosis. Elevated reactive oxygen species (ROS) accelerate follicular atresia, and extracellular matrix remodeling contributes to ovarian damage, while immune dysregulation and cytokine imbalances further exacerbate the condition. The presence of OEMs does not significantly affect live birth rates in in vitro fertilization (IVF) treatments, despite potential reductions in the quality and quantity of oocytes. However, their surgical excision compromises the ovarian reserve. This review highlights the complex mechanisms by which OEMs impair ovarian function and emphasizes the need for further research to develop strategies that mitigate these effects, ultimately improving reproductive outcomes for women with endometriomas. Full article
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17 pages, 593 KiB  
Review
Prolactin and Hyperprolactinaemia in Endometriosis-Related Infertility: Are There Clinically Significant Connections?
by Ranko Kutlesic, Marija Kutlesic, Jelena Milosevic-Stevanovic, Predrag Vukomanovic, Milan Stefanovic and Danka Mostic-Stanisic
J. Clin. Med. 2024, 13(19), 5868; https://doi.org/10.3390/jcm13195868 - 1 Oct 2024
Viewed by 2632
Abstract
Endometriosis and hyperprolactinaemia are conditions that might lead to infertility as a consequence. The aim of this article was to present the current knowledge about possible relationships between prolactin/hyperprolactinaemia and endometriosis-related infertility. Experimental studies on local prolactin acting as cytokine and relationship of [...] Read more.
Endometriosis and hyperprolactinaemia are conditions that might lead to infertility as a consequence. The aim of this article was to present the current knowledge about possible relationships between prolactin/hyperprolactinaemia and endometriosis-related infertility. Experimental studies on local prolactin acting as cytokine and relationship of prolactin and endometriotic tissue, as well as clinical studies on hyperprolactinaemia and endometriosis-related infertility suggest the possible role of prolactin in endometriosis-related infertility, but final proof is still missing and the exact pathogenesis of infertility in such cases is still under investigation. Novel strategies in the treatment of endometriosis-related infertility, based on its connection with prolactin such as the use of prolactin receptor antibodies and prolactin receptor antagonists, are under investigation, but adequate clinical studies have yet to be undertaken. Full article
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13 pages, 276 KiB  
Review
The Impact of Laparoscopic Surgery on Fertility Outcomes in Patients with Minimal/Mild Endometriosis
by Georgios Grigoriadis, Horace Roman, Fani Gkrozou and Angelos Daniilidis
J. Clin. Med. 2024, 13(16), 4817; https://doi.org/10.3390/jcm13164817 - 15 Aug 2024
Cited by 1 | Viewed by 3582
Abstract
Minimal/mild endometriosis (MME) is independently associated with reduced fecundity rates. In this review article, we discuss the role of laparoscopic surgery in enhancing the fertility outcomes of patients with MME. Laparoscopic management of MME enhances fecundity and increases the chances of spontaneous conception [...] Read more.
Minimal/mild endometriosis (MME) is independently associated with reduced fecundity rates. In this review article, we discuss the role of laparoscopic surgery in enhancing the fertility outcomes of patients with MME. Laparoscopic management of MME enhances fecundity and increases the chances of spontaneous conception in appropriately selected cases. However, laparoscopy cannot be routinely recommended in asymptomatic patients with the sole purpose of diagnosing and treating potentially present MME. Equally, and based on existing information, the laparoscopic management of MME cannot be routinely recommended prior to in vitro fertilisation (IVF) attempts due to the lack of robust and beneficial evidence. Because an overlap between unexplained infertility and MME cases likely exists, the development of reliable, widely available, non-invasive tests for the diagnosis of MME may revolutionise the management of cases currently classified as unexplained infertility. In a disease as diverse as endometriosis, management decisions should be based on a multitude of factors. Future studies should focus on reporting the outcomes of interventions for MME on fertility and obstetric outcomes, clearly differentiating between disease stages and phenotypes. Full article
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