Uterine microbiota in endometriosis: potential biomarkers of disease and infertility treatment outcome

Endometriosis is one of the most common reproductive disorders affecting women. Characterized by the presence of endometrial tissue outside the uterine cavity, it is a heterogeneous disease that can affect different anatomical sites, mainly the ovaries and the peritoneum. All forms of endometriosis cause varying degrees of pelvic pain, dysmenorrhea, dyspareunia, painful defecation, and/or infertility. Although the estimated prevalence of endometriosis is ~10% in the general female population, it affects an estimated ~50% of infertile women. It is estimated that close to 200 million women worldwide experience endometriosis.

There are different theories of the possible causes of the disease, however the exact mechanisms are still unknown. Furthermore, the classic therapy has not changed in a century, despite the chronic, recurrent nature of this condition. Treatment encompasses the removal of ectopic endometrial lesions by invasive surgery. Diagnosis is currently made through surgical inspection and histologic assessment. However, the invasiveness of this approach means that diagnosis can be delayed for many years, estimation of 5-10 years. Reducing the time to diagnosis would not only improve the field of endometriosis management, but also enhance the quality of life of affected women. There is strong international recognition that accurate non-invasive / minimally-invasive diagnostic markers and more effective disease modifying agents are needed for this commonly occurring disease. MENDO project aims to analyse uterine microbiota in order to identify minimally invasive molecular biomarkers of endometriosis and successful infertility treatment outcomes.