**Section 4**

**Diagnosis and Treatment** 

416 Endometriosis - Basic Concepts and Current Research Trends

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Yoshida M. Role of glutathione in the maturation and fertilization ofpig oocytes in vitro.

in pig oocytes matured in vitro. Mol Reprod Dev 1992; 31:68-71.

Mol Reprod Dev 1993; 35:76-81.

**23** 

 *Italy* 

**Current Insights and Future Advances in** 

 *Faculty of Medicine and Surgery of Second University of Naples, Naples,* 

Endometriosis is a benign gynaecological disease characterized by the presence of endometrial glands and stroma outside the uterine cavity. This condition is mainly found in women of reproductive age, from all ethnic and social groups and it is associated with pelvic pain and infertility. Endometriosis is typically present in the pelvis such as on the ovaries and pelvic peritoneum, but may also involve the bowel, ureter or bladder. It regresses after menopause or ovariectomy, suggesting it could depend on the production and metabolism of sex steroids: high concentrations of estrogens were found in the endometriotic lesions, which grow and regress in an oestrogen-dependent way. Nevertheless, the pathogenesis and the molecular mechanism that underlie the development of endometriosis have troubled the investigators through many years, remaining an enigma. The disease is widely accepted to result from the ectopic implantation of refluxed menstrual tissues. In addition, immunologic changes, environmental, hormonal

Many studies are therefore focusing on identifying markers for the diagnosis and follow-up of endometriosis. Although the ''gold standard" for the diagnosis of endometriosis is the laparoscopy, many reports have suggested that various serum, peritoneal fluid and tissue markers might be associated with endometriosis. In fact, the identification of more sensitive and specific markers of endometriosis should facilitate the development of accurate and non-invasive techniques for diagnosis and prognosis (Table 1). Furthermore, the inheritable susceptibility to endometriosis justifies the growing interest in identifying genes and/or genetic polymorphisms that could lead to an increased risk of disease. Identifying these

Over the last 20 years, several proteomics technologies have been used to research novel proteins with a potential etiological role in endometriosis, and to identify candidate serum markers for this condition. While some molecules identified by proteomics technologies may have a relevant role in the pathogenesis of endometriosis, the research of potential

The early diagnosis of endometriosis could prevent the possible progression of

and genetic factors contribute to the multifactorial etiology of endometriosis.

polymorphisms may open to their use as genetic biomarkers of endometriosis.

serum markers for this condition is still far from any clinical application.

endometriosis, resulting in more pain, infertility and in a declining quality of life.

**1. Introduction** 

**Endometriosis Diagnostics** 

Michele Cioffi and Maria Teresa Vietri

*Department of General Pathology,* 
