Pathogenesis of endometriosis: Classic theories and recent data

Papadias K, Αvgoulea A, Lambrinoudaki I, Κreatsa M, Christodoulakos G

2nd Dept. of Obstetrics & Gynecological Clinic, University of Athens, “Aretaieio Hospital”, Athens, Greece

Correspondence: Lambrinoudaki Irene, 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, 76 Vasilissis Sofias Avenue, GR-11528, Athens, Greece. E-mail:


Endometriosis is an enigmatic disease, as the etiopathogenetic mechanism remains still unclarified. The classic theories of implantation, induction and metaplasia are unable to give an explanation for all the cases of endometriosis. Based on the classic theories and mainly on the implantation theory of Sampson, many authors tried to analyze immunologic mechanisms responsible for the establishment of endometriosis. Recent studies suggest that immunologic mechanisms are responsible for the woman who develops endometriosis because they aid the attachment, the survival and the development of the ectopic endometriotic tissue. Other studies have focused in endocrinological and environmental factors that have important impact in the pathogenesis of the disease. Genetic factors and gene polymorphisms are also implicated in the development of this disease.

Keywords: pathogenesis, endometriosis, implantation theory, immunologic mechanisms

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