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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
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The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
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Infertility in Females01:28

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Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
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The menstrual cycle is a recurrent sequence of changes in the uterine endometrium, specifically its functional layer, the stratum functionalis. This cycle prepares the uterus for potential pregnancy. This cycle typically spans 21–35 days, averaging 28 days, and aligns with the ovarian cycle, regulated by fluctuating levels of ovarian hormones, primarily estrogen and progesterone.
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Rise and Rise of Endometriosis-An Enigma.

Sujata Dalvi1

  • 1Nowrosjee Wadia Maternity Hospital, Mumbai, India.

Journal of Obstetrics and Gynaecology of India
|June 30, 2025
PubMed
Summary
This summary is machine-generated.

Endometriosis, a chronic inflammatory disease, causes debilitating pain and impacts fertility. Diagnosis delays are common, necessitating medical therapy, surgery for severe cases, and assisted reproductive technology for improved fertility outcomes.

Keywords:
DIE–deep infiltrating endometriosisEndometriosisLaparoscopyOestrogen

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Area of Science:

  • Gynecology
  • Reproductive Medicine
  • Pathology

Background:

  • Endometriosis is a chronic, estrogen-dependent inflammatory condition impacting quality of life.
  • It is associated with menstruation, heightened estrogen receptor sensitivity, and reduced progesterone levels, leading to pain via prostaglandins.
  • Delayed diagnosis is frequent due to non-specific symptoms, affecting fertility and well-being.

Discussion:

  • Current diagnostic methods like imaging and biomarkers lack specificity; definitive diagnosis relies on laparoscopy and histopathology.
  • Medical therapy is the primary treatment for pain and fertility, with surgery reserved for severe or deep infiltrating endometriosis (DIE).
  • Assisted reproductive technology (ART) can enhance fertility outcomes post-surgery, though recurrence is possible.

Key Insights:

  • Endometriosis significantly impairs quality of life and fertility.
  • Laparoscopy and histopathology remain the gold standard for diagnosis.
  • A multi-modal treatment approach, including medical, surgical, and ART, is often required.

Outlook:

  • Further research into specific biomarkers and less invasive diagnostic techniques is warranted.
  • Optimizing treatment strategies to minimize recurrence and improve long-term outcomes is crucial.
  • Understanding the underlying mechanisms of estrogen dependence and inflammation may reveal novel therapeutic targets.