Diagnosis of Endometriosis

*Endometriosis*

2010;**118**(6):825-832

2013;**126**:91-97

human data. The Journal of Clinical Endocrinology and Metabolism. 2015;**100**(12):E1502-E1511

[120] Weuve J, Hauser R, Calafat AM, Missmer SA, Wise LA. Association of exposure to phthalates with

[121] Upson K, Sathyanarayana S, De Roos AJ, Thompson ML, Scholes D, Dills R, et al. Phthalates and risk of endometriosis. Environmental Research.

Cardeal ZL, Carneiro MM, André LC. Study of possible association between endometriosis and phthalate and bisphenol A by biomarkers analysis. Journal of Pharmaceutical and

Biomedical Analysis. 2019;**172**:238-242

[122] Moreira Fernandez MA,

endometriosis and uterine leiomyomata: Findings from NHANES, 1999-2004. Environmental Health Perspectives.

**46**

**49**

**1. Background**

**Chapter 3**

**Abstract**

*and Warren G. Foster*

microRNA and Overcoming the

Challenges of Their Use in the

Diagnosis of Endometriosis

*Victoria Turpin, Anna Leonova, Sanjay K. Agarwal* 

diagnostic marker or panel of markers for the diagnosis of endometriosis.

Endometriosis is a common estrogen dependent and progesterone resistant disease of unknown cause characterized by growth of endometrial cells outside the uterine cavity [1]. It is estimated that 6–11% of all women are affected by endometriosis reaching an estimated 176 million women globally [2]. A chronic painful disease [3], endometriosis causes substantial health distress and interference with normal activities including work resulting in an average loss of 10.8 h/ week from work [2] all leading to diminished quality of life (QOL) for affected women and their families. Chronic pelvic pain and infertility are common symptoms of endometriosis that bring women with this disease to seek medical attention. Approximately 71–87% of all women experiencing chronic pelvic pain and 50% of infertile women are diagnosed with endometriosis [4]. Thus, women with

**Keywords:** microRNA, miRNA, diagnosis, plasma, endometriosis

Endometriosis is a common estrogen dependent and inflammatory disease affecting approximately 176 million women worldwide. Currently, the time between onset of symptoms and a definitive diagnosis has been reported by several international studies to range from 6 to 12 years. Presently, laparoscopic surgery followed by histopathological confirmation of lesions remains the gold standard for diagnosis. In part because of cost and invasiveness, current trends favor reduced laparoscopic surgeries in preference of the non-surgical diagnosis of endometriosis. However, the search for a clinical marker or markers of endometriosis that provide equal or similar sensitivity and specificity to laparoscopy has remained elusive. Thus, the search for a diagnostic test for the diagnosis of endometriosis continues to be a high priority research and clinical issue. Recent studies have reported favorable results with microRNA; however, lack of replication and absence of validation suggest that circulating miRNA may not be reliable for clinical use. Use of different screening platforms together with divergent methods may account for some of the lack or reproducibility in the literature. Herein we critically assess the recent literature and explore sources for discrepant findings. We suggest that prospective studies using validated reference miRNA to normalize results together with improved study design may yet reveal a suitable
