New considerations for the pathogenesis of endometriosis

Objectives: To review the available evidence regarding the immunological, epidemiological and other factors involved in the pathogenesis of endometriosis. Methods: Literature review. Results: Endometriosis remains a poorly-understood disease of unknown etiology and pathogenesis. Conclusions: There is evidence to suggest that alterations in the immune response, whether genetically transmitted or environmentally induced, predispose women to the ectopic implantation of endometrial cells transported into the peritoneal cavity by way of retrograde menstruation. This predisposition may exist because of an impaired peritoneal clearing of endometrial cells and fragments or because of pathological angiogenesis. (C) 2002 International Federation of Gynecology and Obstetrics.