Tratamiento de la endometriosis con 5 mg o 25 mg diarios de mifepristona durante 6 meses. Ensayo clínico aleatorizado,doble ciego

Objectives

To evaluate the safety and efficacy of 5 mg and 25 mg doses of mifepristone for the treatment of endometriosis.

Design

Randomized double-blind study.

Setting

Eusebio Hernández Hospital, Havana, Cuba.

Subjects

Twenty-six women laparoscopically diagnosed with endometriosis were included.

Treatment

Group I received one tablet of 25 mg mifepristone daily and group II received one tablet of 5 mg mifepristone daily for 6 months. Laparoscopy and endometrial biopsy were performed before and after treatment.

Variable to evaluate efficacy

Reduction in the intensity of dysmenorrhea measured by a visual analogue scale.

Results

In both groups reductions in the intensity of dysmenorrhea and dyspareunia were highly significant compared with initial values (P <.001). All the women were amenorrheic after 45 days of treatment.

Conclusions

At doses of 5 mg or 25 mg, mifepristone could be an alternative for the treatment of endometriosis.     

Effectiveness of the association micronized N-Palmitoylethanolamine (PEA)-transpolydatin in the treatment of chronic pelvic pain related to endometriosis after laparoscopic assessment: a pilot study

Objective

Aim of our study was to evaluate the effectiveness of the association between N-Palmitoylethanolamine and transpolydatin in the management of chronic pelvic pain related to EMS.

Study design

This was a randomized, double-blind, parallel-group, placebo-controlled clinical trial involving 61 subjects, submitted to a first line laparoscopic conservative surgery, who were randomized into 3 groups receiving: group A (n = 21) the association N-Palmitoylethanolamine-transpolydatin 400 mg + 40 mg twice a day for 3 months; group B (n = 20) the placebo for 3 months; group C (n = 20) a single course of Celecoxib 200 mg twice a day for 7 consecutive days. Assessments of the severity of pelvic endometriosis (pelvic pain, dysmenorrhoea and dyspareunia) were recorded before and after treatment on a questionnaire and a 10-point VAS. Differences between groups were verified with Kruskal-Wallis ANOVA for non-parametric multiple comparisons.

Results

A marked decrease in dysmenorrhoea, dyspareunia and pelvic pain was observed in all groups, and the association between N-Palmitoylethanolamine and transpolydatin resulted to be more effective than placebo (P < .001). Additionally, the treatment with Celecoxib resulted in a decrease in pelvic pain more effective either than the association N-Palmitoylethanolamine and transpolydatin or placebo.

Conclusion

These preliminary results show that the association between micronized N-Palmitoylethanolamine and transpolydatin is effective in the management of pelvic pain related to endometriosis after laparoscopy. Additionally, this association seems to be safe, shows an optimal control of pain and can be used in patients who are unable to receive other therapies.     

Effect of palmitoylethanolamide–polydatin combination on chronic pelvic pain associated with endometriosis: Preliminary observations

Objective

Endometriosis is a chronic oestrogen-dependent gynaecological disorder, the most common symptom of which is pain. Inflammation can be considered one of the major causes of pain in endometriosis. In particular, degranulating mast cells have been found in significantly greater quantities in endometriotic lesions than in unaffected tissues. The increase in activated and degranulating mast cells is closely associated with nerve structures in painful endometriotic lesions. These observations indicate that inflammation due to mast cells may contribute to the development of pain and hyperalgesia in endometriosis. Controlling mast-cell activation may therefore relieve the pain associated with endometriotic lesions.

Study design

Four patients presenting an endometriosis-related pain intensity ≥5 (visual analogue scale for pain, or VAS) were enrolled and monitored during 3 months of the following treatment: oral palmitoylethanolamide 400 mg and polydatin 40 mg, twice daily for 90 days. Deep dyspareunia, dyschezia, dysuria, dysmenorrhoea and analgesic drug use during the 3-month follow-up period were also monitored, with the aim of demonstrating a reliable reduction in chronic pelvic pain.

Results

The preliminary results indicate that all patients enrolled experienced pain relief as early as 1 month after starting treatment. Furthermore, a reduction in the analgesic drugs usually employed for pain control was observed in all subjects treated. Additionally, some improvements in endometriotic lesions seemed to be demonstrated by imaging.

Conclusions

The palmitoylethanolamide–polydatin combination seems to be very useful in controlling chronic pelvic pain associated with endometriosis. As a result of these findings we have initiated a multi-centre pilot study to verify the effectiveness of this treatment in controlling the chronic pelvic pain associated with endometriosis.     

A randomized pilot study of acupuncture treatment for primary dysmenorrhea

Objective

To compare the therapeutic effect of acupuncture and non-steroidal anti-inflammatory drug (NSAID) therapy in primary dysmenorrhea patients.

Study design

Thirty-five young women with a diagnosis of primary dysmenorrhea were recruited for the study. Their dysmenorrhea severity was rated by visual analog scale (VAS) immediately prior to entry into the study. They were randomly divided into two groups; and the following month they were given NSAID (group 1, n = 24) or acupuncture treatment (group 2, n = 11). Pain was rated again using VAS during menstruation in both groups.

Results

After one month's treatment, pain scores were significantly lower in both groups (p < 0.05). Mean pain scores decreased by 52.2% and 69.5% in the NSAID and acupuncture groups, respectively.

Conclusion

Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea. Since this was a pilot study with a small sample size and short follow-up period, larger studies are needed to clarify the effect of acupuncture in the treatment of primary dysmenorrhea.     

Coagulation versus excision of primary superficial endometriosis: a 2-year follow-up

Objective

Even the common mild forms of endometriosis can strongly affect quality of life due to dysmenorrhea, dyspareunia, dyschezia, or subfertility. We compared the effectiveness of the two laparoscopic methods, coagulation versus excision, for intraperitoneal superficial endometriosis with regard to recurrence and symptom control.

Study design

In a retrospective analysis we evaluated the postoperative follow-up of 79 patients, aged 16–42, with superficial manifestation of endometriosis (median rASRM score 9.2) operated on in the Department of Gynecology and Obstetrics at the Jena University Hospital. Forty-three patients were treated by electrocoagulation and 36 underwent sharp excision. Therapy success was evaluated by using a questionnaire after a mean follow-up of 29 months. Patients were interviewed about pain associated with endometriosis such as dysmenorrhea, dyspareunia, dyschezia and possible medical treatment after surgery. We evaluated the number of surgically proven relapses and questionnaire results using a pain score on an ordinal scale (1–5) for the three categories dysmenorrhea, dyspareunia, and dyschezia.

Results

Both treatment methods resulted in a low number of endometriosis-related symptoms after surgical intervention and in recurrences of 2.8% in the coagulation group and 18.6% in the excision group. The recurrence rate in the coagulation group was lower (p = 0.001). The coagulation group was also presented with a significantly lower postoperative pain score at our long-term follow-up (p = 0.0067).

Conclusion

In cases of superficial endometriosis, laparoscopic surgery achieved low recurrence rates and good symptom control. Compared to sharp excision the use of bipolar electrocoagulation might result in fewer endometriosis-related symptoms as well as fewer relapses with need for surgical re-intervention after a more than 2-year interval. Due to the retrospective, non-randomized character of this study the results should be interpreted carefully. Further prospective studies are needed to assess the value of both surgical approaches in the treatment of endometriosis.     

Biopsychosocial correlates of persistent postsurgical pain in women with endometriosis

Objective

To examine pain and biopsychosocial correlates over time for women with persistent postsurgical pain after surgery for endometriosis.

Methods

Cross-sectional study of women who underwent any endometriosis surgery between 2003 and 2006. Following surgery, patients completed validated questionnaires (Short-Form McGill Pain Questionnaire, 12-item Short-Form Health Survey, Beck Depression Inventory, Coping Strategies Questionnaire catastrophizing subscale). The primary outcome was pelvic pain intensity, measured by the McGill total pain score. Bivariate comparisons between each potential predictor and pain intensity were performed using the χ² and t tests, 1-way analysis of variance, and simple linear regression.

Results

In total, 79 completed the questionnaires and were included in the present analysis. The McGill affective pain score was negatively correlated with age (β-coefficient –0.12, P = 0.002) and positively correlated with catastrophization (β-coefficient 0.66, P = 0.01). Women with a history of dyspareunia scored significantly higher on the McGill total pain score (P < 0.001); there was no association between pain intensity and endometriosis severity.

Conclusion

Younger age and catastrophization are correlated with persistent pain following surgery for endometriosis. The severity of endometriosis does not predict persistent pain. Further evaluation of psychosocial factors may identify patients who are least likely to benefit from surgeries for endometriosis-associated pelvic pain.     

Estradiol valerate plus dienogest versus ethinylestradiol plus levonorgestrel for the treatment of primary dysmenorrhea

Objective

To demonstrate the superiority of estradiol valerate plus dienogest (E₂V/DNG) over ethinylestradiol plus levonorgestrel (EE/LNG) in reducing the number of days with dysmenorrheic pain among women with primary dysmenorrhea.

Methods

In a phase IIIb trial conducted at 44 centers worldwide between April 2009 and November 2010, otherwise healthy women aged 14 − 50 years requesting contraception were randomized to daily oral administration of E₂V/DNG (n = 253) or EE/LNG (n = 254) for three 28-day cycles. The primary efficacy variable was number of days with dysmenorrheic pain, the category of which (none, mild, moderate, severe) was self-assessed on a daily basis (irrespective of menstrual bleeding status) and recorded on diary cards. Notably, the women documented their pain as they experienced it before taking any (permitted) rescue medication.

Results

Overall, 217 and 209 women receiving E₂V/DNG and EE/LNG, respectively, completed the study. The mean ± SD change from baseline in number of days with dysmenorrheic pain was –4.6 ± 4.6 days and –4.2 ± 4.2 days for the E₂V/DNG and EE/LNG groups, respectively (P = 0.34).

Conclusion

Both E₂V/DNG and EE/LNG led to considerable relief of dysmenorrheic complaints among women with primary dysmenorrhea, decreasing the number of days with dysmenorrheic pain from baseline to a similar extent.ClinicalTrials.gov:NCT00909857     

Antiproliferative and apoptotic effects of norethisterone on endometriotic stromal cells in vitro

Objectives

Low-dose estrogen–progestin (LEP) agents are often used for relieving endometriosis-associated chronic pelvic pain, but a direct effect of LEP on endometriotic lesions remains to be demonstrated. The objective of this study is to investigate the antiproliferative and apoptotic effects of the synthetic progestin norethisterone (NET) against human endometriotic stromal cells (ESCs).

Study design

Ovarian endometrioma specimens were obtained at laparoscopy from 19 patients with endometriosis, and ESCs were isolated. The antiproliferative effect of compounds against cultured ESCs was evaluated by measuring the inhibition of [³H]thymidine incorporation. The ability of compounds to induce apoptosis in the cultured cells was evaluated by the measurement of caspase 3/7 activity and by nuclear staining. The cytotoxicity of compounds was evaluated by measuring the leakage of lactate dehydrogenase (LDH) into the supernatant of the cell culture.

Results

NET and progesterone (P4) at concentrations of greater than 10 nM significantly inhibited [³H]thymidine incorporation in a dose-dependent manner. Co-treatment with 17β-estradiol at 0.1 ng/mL did not affect the inhibition of [³H]thymidine incorporation by NET. At concentrations greater than 100 nM, NET significantly increased caspase 3/7 activity and the numbers of apoptotic cells, whereas P4 did not. Treatment of ESCs for 24 h with NET or P4 at concentrations of up to 1000 nM did not cause LDH leakage.

Conclusions

NET inhibits the proliferation of ESCs and induces their apoptosis. These results suggest a possible direct effect of NET on endometriotic lesions in patients with endometriosis.     

The influence of endometriosis-related symptoms on work life and work ability: a study of Danish endometriosis patients in employment

Objective

Little is known about the implications of endometriosis on women's work life. This study aimed at examining the relation between endometriosis-related symptoms and work ability in employed women with endometriosis.

Study design

In a cohort study, 610 patients with diagnosed endometriosis and 751 reference women completed an electronic survey based on the Endometriosis Health Profile 30-questionnaire and the Work Ability Index (short form). Percentages were reported for all data. Binary and multivariate logistic regression analyses were used to assess risk factors for low work ability. The level of statistical significance was set at p < 0.025 in all analyses.

Results

In binary analyses a diagnosis of endometriosis was associated with more sick days, work disturbances due to symptoms, lower work ability and a wide number of other implications on work life in employed women. Moreover, a higher pain level and degree of symptoms were associated with low work ability. Full regression analysis indicated that tiredness, frequent pain, a higher daily pain level, a higher number of sick days and feeling depressed at work were associated with low work ability. A long delay from symptom onset to diagnosis was associated with low work ability.

Conclusions

These data indicate a severe impact of endometriosis on the work ability of employed women with endometriosis and add to the evidence that this disease represents a significant socio-economic burden.     

Effective ablation therapy of adenomyosis with ultrasound-guided high-intensity focused ultrasound

Objective

To evaluate the effects of ultrasound-guided high-intensity focused ultrasound (HIFU) on adenomyosis.

Methods

In a retrospective analysis, data were reviewed from 202 patients with adenomyosis who underwent ultrasound-guided HIFU between November 2010 and June 2012 at Suining Central Hospital, Sichuan, China. Among these patients, 120 and 82 were classified as having focal adenomyosis and diffuse adenomyosis, respectively. All patients underwent pre-treatment and post-treatment magnetic resonance imaging by a standardized protocol to evaluate the treatment. All adverse effects were recorded.

Results

All patients completed the ultrasound-guided HIFU treatment in 1 session. A non-perfused volume ratio of 71.6% ± 19.1% was achieved. Compared with baseline data, the average menorrhagia severity score and the average dysmenorrhea severity pain score decreased significantly after ultrasound-guided HIFU (both P < 0.001). The proportion of women with complete relief of dysmenorrhea at the 3-month follow-up was significantly higher among women with focal adenomyosis than among those with diffuse adenomyosis (P = 0.02). No other significant differences were observed between the 2 patient groups.

Conclusion

Ultrasound-guided HIFU was found to be an effective technique for treating both focal and diffuse adenomyotic lesions to alleviate the symptoms of menorrhagia or dysmenorrhea.     

Plasminogen activator inhibitor-1 4G/5G polymorphism and susceptibility to endometriosis in the Italian population

Objectives

Some controversy exists for the potential association of the plasminogen activator inhibitor-1 (PAI-1) gene polymorphism 4G/5G and susceptibility to endometriosis. To clarify this issue, we have examined the prevalence of this polymorphism in a case–control study in the Italian population.

Study design

The PAI-1 4G/5G polymorphism was evaluated in n = 368 reproductive year aged Caucasian women who underwent gynaecological laparoscopy for chronic pelvic pain, infertility, ovarian cysts and myomas. A second group of controls included n = 329 normal subjects.

Results

The 697 women enrolled were divided as follows: the endometriosis group (n = 204), the gynaecological control group (n = 164) and the general population control group (n = 329). No statistical significant differences emerged between endometriosis patients and gynaecological controls with regard to the allele frequencies and co-dominant and dominant models of genotype distribution. A borderline statistical difference was only observed for the recessive model of inheritance in which, contrary to previous findings, the PAI-1 4G/4G genotype seems to be less linked to the disease development.

Conclusion

The findings reported herein do not support the previously reported data indicating a greater susceptibility to endometriosis in patients harbouring the PAI-1 4G/5G and 4G/4G genotypes and exclude a significant role of polymorphism in endometriosis development.     

Flujo sanguíneo de las arterias uterinas en mujeres con dismenorrea primaria

Objective

To identify the parameters of blood flow in the uterine arteries in women with primary dysmenorrhea.

Methods

We selected women attending the Nuestra Señora de Chiquinquirá and Central Dr. Urquinaona hospitals in Maracaibo, Venezuela. There were 40 women with primary dysmenorrhea (group A) and 40 women without dysmenorrhea (group B). Blood flow in the uterine arteries, women's general characteristics, Doppler blood flow parameters in the uterine arteries and symptom severity were evaluated.

Results

The mean age was 28.3 ± 5.8 years in group A and 26.4 ± 5.0 years in group B (P=ns). Doppler ultrasound evaluation was performed on the second day of menstruation in all women in both groups. The pulsatility index, resistance index and systolic / diastolic ratio of the uterine arteries in women with a diagnosis of primary dysmenorrhea were significantly higher than in controls (P<.05). The uterine artery resistance index showed a moderate, positive and significant correlation with pain intensity (r = 0.570; P<.05).

Conclusion

Women with dysmenorrhea showed alterations in uterine artery blood flow compared with women without dysmenorrhea.     

The occurrence of endometriosis with ovarian carcinomas is not purely coincidental

Objective

To explore the association between epithelial ovarian cancer (EOC) and common benign gynecological disorders.

Study design

The medical records of 226 patients with EOC treated at Peking Union Medical College Hospital between March 2011 and March 2012 were reviewed. Histological evaluations had been performed to determine the presence of coexisting pelvic endometriosis (n = 17), uterine leiomyoma (n = 66), adenomyosis (n = 22), or endometrial polyps (n = 17).

Results

Coexistence of endometriosis occurred in 35.3% and 36.4% of cases of the clear cell and endometrioid subtypes of EOC histology, respectively. Endometriosis was more likely associated with clear cell or endometrioid ovarian carcinoma, but less likely with high grade serous cancer. No differences were observed in the concurrence of uterine myoma, adenomyosis or endometrial polyps among the different subtypes of EOC.

Conclusions

In contrast to other common benign gynecological disorders, endometriosis showed close relationships with the clear cell and endometrioid subtypes of EOC specifically.     

The effectiveness of an educational intervention on proper analgesic use for dysmenorrhea

Objectives

Primary dysmenorrhea is a common gynecologic disorder, but is often inappropriately managed due to ignorance and misunderstanding of its pharmacotherapy in many young women. The aim of this study was to assess the effectiveness of an educational intervention on proper analgesic use for dysmenorrhea among Korean female university students.

Study design

In March 2008, an educational intervention, a 10-min lecture using supplementary educational printed materials, was given to the intervention group (n = 98). Two months later, changes and differences in knowledge, actual medication behavior, coping strategies, dysmenorrhea severity (VAS score), and Korean health-related quality of life (KQOLS) were assessed between the intervention and control (n = 105) groups.

Results

The prevalence of dysmenorrhea in the intervention and control groups was 75.1% and 77.1%, respectively. After the educational intervention, the medication rate of the intervention group was significantly increased (from 36.1% to 51.0%, P = 0.007), and the knowledge of and actual behavior relating to the proper analgesic use were also significantly improved in this group. The VAS scores were significantly decreased among participants with dysmenorrhea in the intervention group (from 48.6 ± 22.0 to 37.8 ± 22.5, P < 0.001). In addition, significant improvements in two domains of the KQOLS, physical function (from 89.3 ± 11.1 to 93.1 ± 8.8, P = 0.007) and pain (from 80.4 ± 19.9 to 87.4 ± 14.3, P = 0.001), were observed in the intervention group.

Conclusions

The findings of this prospective study suggest that a brief educational intervention can improve the severity of dysmenorrhea and the quality of life by enhancing medication knowledge and actual analgesic behavior in Korean female university students.     

Endometriosis prophylaxis and treatment with the newly developed xenogenic immunomodulator RESAN in an animal model

Objective

The objective was to assess the effectiveness of the newly developed immunomodulator RESAN in the prophylaxis and treatment of endometriosis induced in rats.

Study design

The study was performed on 58 Wistar rats. Twelve weeks before endometriosis induction, the RESAN vaccine was administered to 24 rats (100 mg i.m. and 100 mg s.c.). Endometriosis induction was performed in 48 rats, which were divided into two groups: group I, the prophylaxis group, consisting of 24 previously vaccinated rats; and group II, the treatment group, comprising the other 24 rats, which had not been vaccinated. The graft (4 mm × 4 mm) of endometrium was attached to the parietal peritoneum. A sham operation was performed in 10 rats (group III). After 3 months, a second laparotomy was performed in all animals, and endometriotic foci were excised when present. RESAN was administered to the group II animals. After an additional 3 months, a third laparotomy was performed in all animals of the three groups.

Results

Positive, histologically confirmed endometriosis was found in 4.3% of the animals in group I and in 69.6% of group II rats (p < 0.0001). Macroscopic assessment revealed endometriosis in 21.7% and 91.3% of animals in groups I and II, respectively (p < 0.0001). At final laparotomy, 3 months after excision of the previously suspected foci, no signs of endometriosis were found according to both macroscopic assessment and histological examination. During the second laparotomy intraperitoneal adhesions were present in 13.0% of the animals in group I and in 61.0% of those in group II. No adhesions were present in group III. At the final laparotomy, the adhesions were present in only three of the animals in group II (p < 0.0009).

Conclusions

RESAN seems to be effective in both the prophylaxis and treatment of endometriosis, as well as in the prophylaxis of adhesions. Histological confirmation of endometriosis should be mandatory.     

More than just bad sex: sexual dysfunction and distress in patients with endometriosis

Objectives

The aim of the current study was to evaluate the prevalence and the impact of sexual dysfunction, sexual distress and interpersonal relationships in patients with endometriosis.

Study design

A questionnaire-based multicentre cohort study was conducted in eight tertiary referral centres in Austria and Germany. One hundred and twenty-five patients with histologically proven endometriosis and dyspareunia were included. The Female Sexual Function Index and the Female Sexual Distress Scale were used to screen women's sexuality. Additionally, we evaluated psychological parameters and pain intensity during/after sexual intercourse via a self-administered questionnaire.

Results

Female sexual distress and sexual dysfunction were observed in 97/125 and 40/125 patients. Statistically significant correlations were found between sexual dysfunction and pain intensity during/after sexual intercourse (p < 0.01/p < 0.01), a lower number of episodes of sexual intercourse per month (p < 0.01), greater feelings of guilt towards the partner (p < 0.01) and fewer feelings of feminity (p < 0.01). Thirty-eight out of 125 women agreed that the primary motivation for sexual intercourse was to conceive and nearly half of women (46%) included stated that satisfying the partner acted as primary motivation for sexual contact.

Conclusion

Overall, our findings demonstrate that dyspareunia as a common complaint in patients with endometriosis causes a severe impairment of sexual function, relationship and psychological wellbeing.     

The V109G polymorphism in the p27 gene is associated with endometriosis

Objective

To investigate the prevalence of the p27 gene polymorphism in women with endometriosis.

Study design

Transversal case–control study. Genomic DNA was extracted from cells collected from buccal swabs. The p27 V109G polymorphism was investigated using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in a hospital-based Brazilian population.

Results

We analysed the 104 patients and 109 control subjects. The distribution of genotype and allele frequencies of p27 V109G polymorphism was significantly different between the endometriosis cases and healthy women (p = 0.016 and 0.002). Women who had at least one mutated allele presented twofold chances for endometriosis development (OR = 1.9; 95% CI, 1.120–3.343).

Conclusion

The polymorphic variant at codon 109 of the p27 gene seems to be associated with higher risk of endometriosis development.     

Efficacy of montelukast,a leukotriene receptor antagonist,for the treatment of dysmenorrhea: A prospective,double-blind,randomized, placebo-controlled study

Objective

To investigate the effectiveness of montelukast, a leukotriene receptor antagonist, in alleviating the symptoms of dysmenorrhea.

Study design

This prospective, double-blind, randomized, placebo-controlled study was comprised of 62 patients with dysmenorrhea who were randomly divided into 2 groups (montelukast and placebo). Data obtained from 50 patients were analyzed (montelukast: 24; placebo: 26). Using visual analog scale (VAS) scores and nonsteroidal anti-inflammatory drug (NSAID) usage per menstrual cycle, values before treatment were compared to average scores over two menstrual cycles with treatment.

Results

Both the VAS scores and NSAID usage decreased significantly in both groups. The decreases were greater in the montelukast group compared to the placebo group, but the differences were not statistically significant. Nevertheless, in “highly effective cases,” which were defined as having a post-treatment value less than half of the pre-treatment value, the decreases were significantly greater in the montelukast group than in the placebo group (VAS: montelukast, 4 vs. placebo, 0 (P = 0.029); NSAID: montelukast, 9 vs. placebo, 3 (P = 0.031)).

Conclusions

The present study found that montelukast may be effective in alleviating pain associated with dysmenorrhea in some women. Montelukast is safe and does not influence hormonal levels. Therefore, montelukast is a clinically reasonable management option to consider before prescribing a hormonal agent.     

Polymorphic variants of DNMT3A and the risk of endometriosis

Objective

Overexpression of DNA methyltransferase 3A (DNMT3A) and aberrant methylation of various genes in eutopic endometrium have been demonstrated in women with endometriosis. We aimed to study whether DNMT3A polymorphisms could be a genetic risk factor for endometriosis and endometriosis-related infertility.

Study design

We studied 5 SNPs (rs2289195, rs7590760, rs13401241, rs749131 and rs1550117) located in the DNMT3A gene in 357 women with endometriosis and 640 controls.

Results

We did not observe significant differences between genotype and allele frequencies of rs2289195, rs7590760, rs13401241, rs749131 and rs1550117 SNPs in women with endometriosis, endometriosis-related infertility, and controls. The lowest p values of the trend test were observed for DNMT3A rs1550117 in endometriosis and endometriosis-related infertility (p_trend = 0.049 and p_trend = 0.055, respectively).

Conclusions

Our results did not supply evidence for the contribution of SNPs located in DNMT3A to either endometriosis or endometriosis-related infertility.