title: Future directions in endometriosis research.
abstract: Future research in endometriosis must focus on pathogenesis studies in the baboon model, the early interactions between endometrial and peritoneal cells in the pelvic cavity at the time of menstruation, and potential differences between eutopic endometrium and myometrium in women with and without endometriosis. More integration is needed between the areas of epidemiology and genetics. Pelvic inflammation in women with endometriosis could be the target for new diagnostic and therapeutic approaches. Important questions remain regarding the relationship between endometriosis and environmental factors. Systemic and extrapelvic manifestations of endometriosis must be analyzed carefully, and better tools are needed to measure quality of life in women with chronic pain caused by endometriosis. Most current evidence supports a causal relationship between endometriosis and subfertility, and the spontaneous progressive nature of endometriosis has been demonstrated in 30% to 60% of patients. Recurrence of endometriosis after classic medical and surgical therapy is a major and underestimated problem, especially in women with advanced disease. Integrated clinical and research teams are needed that combine expert medical, surgical, and holistic care with state-of-the-art research expertise in immunology, endocrinology, and genetics to discover new diagnostic methods and medical treatments for endometriosis.
authors.affiliation: Leuven University Fertility Center, Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, 3000 Leuven, Belgium. thomas.dhooghe@uz.kuleuven.ac.be
authors.forename: Thomas M
authors.initials: TM
authors.lastname: D'Hooghe
authors.forename: Sophie
authors.initials: S
authors.lastname: Debrock
authors.forename: Christel
authors.initials: C
authors.lastname: Meuleman
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Hill
authors.forename: Jason M
authors.initials: JM
authors.lastname: Mwenda
mesh_terms: D000818:Animals; D004715:Endometriosis / Q000209:etiology* / Q000503:physiopathology* / Q000628:therapy; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007155:Immunologic Factors; D007246:Infertility / Q000209:etiology; D023421:Models, Animal; D011788:Quality of Life; D027724:Reproductive Techniques, Assisted; D012106:Research; D014599:Uterus / Q000502:physiology
chemical_list: D007155:Immunologic Factors