Role of eutopic endometrium in pelvic endometriosis

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is considered a benign gynecologic condition; however, in some cases, it may be aggressive. The pathogenesis of endometriosis is complex and multifactorial. Despite being one of the most widely studied gynecologic diseases, its pathogenesis remains uncertain. The intrinsic endometrial abnormalities thought to be associated with endometriosis include abnormal expression of genes, modification of endometrial response to hormones such as progesterone; increased nerve density, and oxidative stress. Evaluation of the endometrium in patients with endometriosis is an important line of investigation in the pathophysiology of the disease. It has been suggested that investigation of eutopic endometrium may help to achieve this goal. Presented herein is a literature review and a comprehensive evaluation of the role of eutopic endometrium in pelvic endometriosis. Clinical correlations of the disease are highlighted, with the objective of understanding the role of eutopic endometrium in endometriosis.