Abnormal pathways in endometriosis in relation to progesterone resistance: a review

Introduction: Endometriosis is an estrogen-dependent disorder, and recent studies suggest that progesterone resistance may contribute to the development and pathophysiology of the disorder. Based on this, identification of genetic and molecular perturbations in the endometrium of women with endometriosis is an important step towards understanding the pathogenesis of the disease, and the development of novel treatment and diagnostic strategies. Methods: A systematic literature search in PubMed and Embase was performed, and 118 articles were identified for further screening. Two reviewers performed article screening independently using Covidence, and 16 studies fulfilled the inclusion criteria. The Newcastle-Ottawa Scale was used to assess the quality of these studies. Results: This review presents data from eutopic endometrial biopsies from women with and without endometriosis. Several biomarkers related to a downregulated progesterone response were identified and discussed in detail. conclusions: Our review demonstrates significant results concerning the biomarkers investigated, which may substantiate the theory of progesterone resistance in women with endometriosis. However, further research is necessary to determine their specific role and relevance.