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2010, Número 2

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Rev Mex Med Repro 2010; 2.3 (2)


Mecanismos patogénicos de la infertilidad asociada con endometriosis

Gupta S, Goldberg JM, Aziz N, Goldberg E, Krajcir N, Agarwal A

Idioma: Español
Referencias bibliográficas: 98
Paginas: 83-97
Archivo PDF: 251.11 Kb.


RESUMEN

Objetivo: revisar los mecanismos mediante los cuales la endometriosis puede afectar la función reproductiva.
Diseño: revisión de la bibliografía en inglés desde 1986 hasta 2007 después de realizar una búsqueda en Medline, EMBASE, Cochrane, y BIOSIS, así como resúmenes de congresos.
Marco: el centro de investigación de fertilidad y el departamento de ginecología y obstetricia de un hospital de tercer nivel de atención.
Resultados: existen pruebas convincentes en la bibliografía de que la endometriosis tiene efectos perjudiciales en la función ovárica y de las trompas y en la receptividad uterina, dando como resultado infertilidad femenina. Los mecanismos de infertilidad asociados con la endometriosis siguen sendo controversiales e incluyen foliculogénesis anormal, estrés oxidativo elevado, función inmunológica alterada, y entorno hormonal en los ambientes folicular y peritoneal, y receptividad endometrial reducida. Estos factores dan como resultado mala calidad de los oocitos, y deterioro de la fertilización y la implantación.
Conclusión: desenredando los mecanismos por los cuales la endometriosis conduce a la infertilidad, los investigadores están seguros de encontrar un medio no quirúrgico para diagnosticar endometriosis, probablemente a través de marcadores séricos y peritoneales. Las citocinas, interleucinas, marcadores de estrés oxidativo y las moléculas solubles de adhesión celular muestran potencial para ser utilizados como un marcador confiable para el diagnóstico de endometriosis. Después de analizar los mecanismos patogénicos de la endometriosis, parece que el tratamiento futuro de este padecimiento puede incluir inhibidores de ciclo-oxigenasa, inmunomoduladores, o terapia de supresión hormonal para eliminar la necesidad del tratamiento quirúrgico de la endometriosis.


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