After endometriosis surgery chances of conception are high

After endometriosis surgery chances of conception are high

Women who have had surgery for deep infiltrating endometriosis and want to get pregnant have a reasonably high chance of conception, even after multiple failed in vitro fertilization (IVF) attempts, a new study suggests.

The study, “Pregnancy rates after surgical treatment of deep infiltrating endometriosis in infertile patients with at least 2 previous IVF / ICSI failures,” was published in the Journal of Minimally Invasive Gynecology.

Endometriosis can cause infertility, and there has been debate about how to manage this for people who want to get pregnant – specifically, whether it is better to try assisted reproductive techniques (eg IVF) before or after surgery.

In the new study, researchers looked at clinical data from the CIRENDO database, which records such data for people with endometriosis who are managed at one of several clinics in France.

The researchers specifically looked at patients younger than 43 who had undergone at least two previous IVF attempts, had endometriosis surgery, and stated a desire to become pregnant after surgery.

The researchers identified records for 73 patients matching these criteria and with at least one year’s worth of post-surgical data. Most of these patients had stage IV endometriosis; the average number of previous IVF attempts was 3.7.

At the time the data was available, 32 (43.8%) of the patients became pregnant, and 23 of these pregnancies had a live birth. The remaining pregnancies were ectopic (two), molar (one), or followed by an early miscarriage (six).

Of pregnancies, most occur after the introduction of medical assistance (eg IVF); seven of them (21.8%) occurred without additional medical intervention. The average time between surgery and conception was 11.1 months.

The researchers constructed statistical models in order to compare women who did get pregnant to those who did. They found three variables that were significantly associated with a lower likelihood of conception: having ovarian surgery, being 35 or older, and having a lower endometriosis stage.

Overall, this study shows a relatively high rate of pregnancies (and births) among women with endometriosis who have struggled with conception after undergoing surgery. This suggests that post-surgery pregnancy should be fully considered, even in cases that might seem to suggest otherwise.

The researchers said, “Many of our patients had four IVF procedures or were on the waiting list for oocyte donation and eventually had to undergo surgery to relieve their pain after giving up any hope of pregnancy. For these reasons, our results may encourage surgeons to do their best to maintain the uterus even in women who ‘have no hope of getting pregnant.’ ”

They concluded: “These encouraging results of experienced surgical teams working hand-in-hand with assisted reproductive techniques teams in multidisciplinary expert centers suggest that this is the way forward.”

Read more: https://www.jmig.org/article/S1553-4650%2819%2930413-3/fulltext

Source: www.endometriosisnews.com

OB-GYNs hesitate to talk about fertility

OB-GYNs hesitate to talk about fertility

Many OB-GYNs are uncomfortable counseling their patients on fertility at a time when more women are delaying pregnancy and needing their doctors to be more vigilant about this education, according to a new study.

“We found that most OB-GYNs don’t bring up fertility with every patient, often because they believe the patient would bring it up if she wanted to discuss it,” said Rashmi Kudesia, M.D., reproductive endocrinology and infertility specialist at Houston Methodist and CCRM Houston and lead author on the study, published in the Journal of Reproductive Medicine. “It’s a missed opportunity when OB-GYNs don’t start the conversation because many women are routinely exposed to conflicting information about fertility, leading many to believe that they’ll have no issues conceiving and delivering.”

In fact, 82% of OB-GYNs surveyed believe women receive mixed messages about their optimal fertility window, and 68% said women seem to believe they can indefinitely postpone making childbearing plans.

“It isn’t unusual for women to believe that assisted reproductive technologies like IVF are their safety net because they hear so many success stories,” Kudesia said. “The reality is that IVF only has a 5% success rate for women in their mid-40s.”

Kudesia and her co-authors found that OB-GYNs were more likely to provide fertility counseling to married women between the ages of 27-40. For all age groups, single and lesbian women were less likely to receive fertility counseling than married women. It was also found that the 117 physicians who participated provided more counseling on contraception than fertility in nearly all age and relationship status groups.

“The results tell me that regardless of current relationship status or future plans for pregnancy, women need to bring up fertility at their next well-woman exam or ask for a referral to a fertility specialist,” Kudesia said. “Women who want to wait several years and even those who think they don’t want kids at all should still talk to their doctor about fertility so that they can make an informed decision about what is best for them.”

Source: https://www.houstonmethodist.org/newsroom/research-shows-ob-gyns-hesitate-to-talk-about-fertility/

Read more: http://www.reproductivemedicine.com/toc/auto_abstract.php?id=24782

Vaping may harm fertility in young women

Vaping may harm fertility in young women

E-cigarette usage may impair fertility and pregnancy outcomes, according to a mouse study published in the Journal of the Endocrine Society.

Many young and pregnant women are using e-cigarettes as a safer alternative to smoking, but little is known about the effects on fertility and pregnancy outcomes.

E-cigarettes are driving increases in tobacco product use among youth. According to the Centers for Disease Control and Prevention, the number of middle and high school students using e-cigarettes rose from 2.1 million in 2017 to 3.6 million in 2018 — a difference of about 1.5 million youth.

“We found that e-cigarette usage prior to conception significantly delayed implantation of a fertilized embryo to the uterus, thus delaying and reducing fertility (in mice),” said the study’s corresponding author, Kathleen Caron, Ph.D., of University of North Carolina at Chapel Hill, N.C. “We also discovered that e-cigarette usage throughout pregnancy changed the long-term health and metabolism of female offspring — imparting lifelong, second-generation effects on the growing fetus.”

In this study, researchers used a mouse model to examine whether e-cigarette exposure impairs fertility and offspring health. After exposure to e-cigarette vapor, female mice showed decreased embryo implantation and a significant delay in the onset of pregnancy with the first litter. Female offspring exposed to e-cigarettes in utero also failed to gain as much weight as control mice by the 8.5-month mark.

“These findings are important because they change our views on the perceived safety of e-cigarettes as alternatives to traditional cigarettes before and during pregnancy,” Caron said.

Read more: https://academic.oup.com/jes/advance-article/doi/10.1210/js.2019-00216/5560172

Source: https://www.endocrine.org/news-room/2019/vaping-may-harm-fertility-in-young-women

Breastfeeding for cancer prevention

Breastfeeding for cancer prevention

One of the many benefits of breastfeeding is that it can lower a mother’s risk of some cancers.

Most people know there are many benefits to breastfeeding. We’ve probably all heard that it’s the best source of nutrition for most babies and provides many health benefits for infants.

The health benefits for women who breastfeed, however, are less commonly known. In addition to lowering a mother’s risk for type 2 diabetes and high blood pressure, breastfeeding can also lower a mother’s risk of breast and ovarian cancers.

A recent study found that only about 1 in 4 people think that a woman is less likely to develop breast cancer later in life if she breastfeeds. It’s important to know that breastfeeding helps not only the baby’s health but also the mother’s health too.

The American Academy of Pediatrics (AAP) recommends that infants be exclusively breastfed for about the first 6 months of life with continued breastfeeding after the introduction of solid foods for 1 year or longer.

Although most infants receive some breast milk, most are not exclusively breastfed or continue to breastfeed as long as recommended. Four out of 5 infants start out breastfeeding, but only 1 in 4 infants are still exclusively breastfed at 6 months.

Breastfeeding is important for overall health. Infants that are breastfed have a lower risk of asthma, obesity, ear and respiratory infections, sudden infant death syndrome, and gastrointestinal infections such as diarrhea.

One reason breastfeeding lowers the risk of cancer may be that when a woman is breastfeeding, she experiences hormonal changes that may delay the return of her menstrual periods. This reduces her lifetime exposure to hormones such as estrogen, which are linked to an increased risk of breast and ovarian cancers.

According to researchers a human milk complex of alpha-lactalbumin and oleic acid (HAMLET) induces apoptosis only in tumour cells, while normal differentiated cells are resistant to its effects, thus providing safe and effective protection against the development of breast cancer. The longer a mother breastfeeds and the more children she breastfeeds in her life, the higher the protection she gets. Breastfeeding for as few as 3 months is associated with reduced ovarian cancer risk. If the mother breastfeeds for at least 13 months, the risk of getting ovarian cancer is 63% lower.

Source: https://blogs.cdc.gov/cancer/2019/08/01/breastfeeding-for-cancer-prevention/




Individualised approach to ‘fertile windows’ could help couples understand when pregnancy is likely to occur

Individualised approach to ‘fertile windows’ could help couples understand when pregnancy is likely to occur

Only 13% of women having menstrual cycles that last 28 days, according to a new study led by UCL and Natural Cycles, a contraceptive app.

The study, published in Nature Digital Medicine is one of the biggest overviews of menstrual cycles to date and analysed data over 600,000 menstrual cycles and 124,648 women from Sweden, USA and the UK. It could help couples better understand when pregnancy is likely and unlikely to occur.

Researchers set out to investigate menstrual cycle characteristics and associations with age, BMI and body temperatures. The findings show an average cycle length is 29.3 days and only around 13% of cycles are 28 days in length. Across the study, 65% of women had cycles that lasted between 25 and 30 days.

The menstrual cycle begins and ends with menstrual bleeding and is divided by ovulation into two phases: the follicular and luteal phases. Researchers found the average follicular phase length was 16.9 days and the average luteal phase length was 12.4 days. The average cycle length decreased by 0.18 days and average follicular phase length decreased by 0.19 days per year of age from 25 to 45 years. The average variation of cycle length for obese women was 0.4 days or 14% higher. Cycle length variability was observed to a lesser extent in non-obese and underweight women.

Co-author, Professor Joyce Harper (UCL Institute for Women’s Health), said: “Our study is unique in analysing over half a million cycles and re-writing our understanding of the key stages. Traditionally studies have concentrated on women who have approximately 28 day cycles and these studies have formed our understanding of the menstrual cycle.

“For the first time our study shows that few women have the text book 28 day cycle, with some experiencing very short or very long cycles. We studied all women who used the app.

“We also demonstrate that ovulation does not occur consistently on day 14 and therefore it is important that women who wish to plan a pregnancy are having intercourse on their fertile days. In order to identify the fertile period, it is important to track other measures such as basal body temperature as cycle dates alone are not informative.”

Co-author, Dr Simon Rowland, Head of Medical Affairs at Natural Cycles, said: “Given the variations in cycle length and follicular phase length that we have described, especially for cycles outside the average range (25-30 days), an individualised approach to identify the fertile window should be adopted.

“Apps giving predictions of fertile days based solely on cycle dates could completely miss the fertile window and it is therefore unsurprising that several studies have shown that calendar apps are not accurate in identifying the fertile window.

“Besides the potential benefits to the individual, fertility awareness apps and the associated databases of fertility data provide a unique opportunity to examine a large number of menstrual cycles in order to improve understanding.”

Data was collected from women using the app between September 2016 and February 2019 aged 18 to 45 and had a BMI between 15 and 50 and had not been using hormonal contraception within the 12 months prior to registration. Users who stated at registration that they had a pre-existing medical condition (polycystic ovarian syndrome, hypothyroidism or endometriosis) or who had menopausal symptoms were excluded.

The authors note the main limitation of this study is that the study population is derived solely from users of the app who may not be representative of the wider population. In particular, only 8% of women in our study were obese compared to 15% of women in the general population.

Professor Harper added, “The widespread use of mobile phone apps for personal health monitoring is generating large amounts of data on the menstrual cycle. Provided that the real-world data can be validated against traditional clinical studies done in controlled settings, there is enormous potential to uncover new scientific discoveries.

“This is one of the largest ever analyses of menstrual cycle characteristics. These initial results only scratch the surface of what can be achieved. We hope to stimulate greater interest in this field of research for the benefit of public health.”

Read more: https://www.nature.com/articles/s41746-019-0152-7

Source: https://www.ucl.ac.uk/news/2019/aug/individualised-approach-fertile-windows-could-benefit-many-women

What is endo belly and why does it occur?

What is endo belly and why does it occur?

Severe bloating in women with endometriosis, also known as “endo belly” is often painful and uncomfortable and takes a toll on self-image.

Endo belly is a complex situation as endometriosis is a complex disease. Even a CT scan, cannot reveal the cause why it is happening. 

There are a few theories: 

  • Endometriosis causes adhesions that can reduce the mobility of the bowel. 
  • Endometriosis lesions can flare at different parts of the menstrual cycle, which can cause an immune response, which includes swelling.
  • The ectopic endometrial tissue growing on other organs, at the time of  menstruation is also bleeding internally, and the body gets inflamed. 
  • Endometriosis patients can be more sensitive in regards to how their intestines and gut process food. Endo belly could be a side effect of the intestines working overtime.

There is no proven explanation on what causes bloating with endometriosis, so there is no official cure for endo belly.

1. Make sure it is only endo belly

Several diseases and conditions are marked by severe swelling. Women with endo are more prone to Small Intestinal Bacterial Overgrowth (SIBO), which is often characterized by painful bloating, constipation, and painful bowel movements. Fibroids or cysts may also lead to bloating as well as Irritable Bowel Syndrom. 

2. Track food and water 

Log food and water intake. It helps you to identify patterns. Get advice from a dietitian/nutritionist about food that your body reacts to.

Nutritionists and wellness advocates recommend mindful eating, which includes sitting upright at the table for meals and undistracted consumption with thorough chewing. All of this helps support digestion and reduce bloating risk.

3. Check your gut 

Try an anti-inflammatory diet. The best way to find your version of this diet is to start with an elimination diet, slowly add things back in, and note when endo belly occurs. Eliminate those foods. Your dietitian can help you through this process.

The following are regularly recommended to endo patients: generally eliminate alcohol, gluten, dairy, eggs, soy, red meat, preservatives, artificial sugars, and caffeine. 

Women report positive experiences with the keto diet and low-carb diets, but also with natural remedies like drinking fresh celery juice first thing in the morning.  

There’s no one diet for endometriosis. You have to see what’s best for you and what you react to.

4. Check your hormones

Endometriosis comes with hormonal imbalance. Keeping blood sugar balanced will help support proper hormone balance. Make an appointment with an endocrinologist. Acupuncture may help balance hormones, it has been found to release norepinephrine and put us in a state of rest and digest, which is when our body can begin healing itself.

5. Workout 

Many women are afraid to workout when they are in pain, but exercising will actually decrease the pain over time, because it helps with the circulation of the blood, reduce stress, and maintain nutrient and oxygen flow to the whole body. Gentle twisting motions will aid in circulation and movement through the abdominal region and help with pain as well as bloating.

6. Get enough sleep

The body repairs itself during deep sleep. Sleep deprivation can cause hormonal and metabolic changes and increase pain and stress responses (and thus bloating), and women with endo often struggle with insomnia. Popular sleep inducing recommendations include lavender scents, blue light phone filters in the evenings, eliminating electronics after a certain time, and chamomile teas. 

7. Limit the stress

Stress fuels endometriosis and its symptoms, and endometriosis creates physical and mental stress, so the cycle needs to be slowed as much as possible. Breathing exercises, physical and emotional therapy, and exercise have been essential for many endo women.

Sources: https://www.endofound.org/endo-belly 



Image: https://www.instagram.com/p/Bfbd_88gkng/ 


Stinging nettle reduces size of lesions in rat model of endometriosis

Stinging nettle reduces size of lesions in rat model of endometriosis

Treatment with the aerial parts of the stinging nettle (Urtica dioica L.), a plant used in traditional medicine, reduced the size of endometrial lesions in a rat model of endometriosis,according to the results of a new study.

The study, “Bioactivity-guided isolation of flavonoids from Urtica dioica L. and their effect on endometriosis rat model,” were published in the Journal of Ethnopharmacology.

U. dioica L., commonly known as the stinging nettle, is a medicinal herb that has been used traditionally for centuries. U. dioica leaves and roots are used as a blood purifier, an emmenagogue (herbs that stimulate blood flow in the pelvic area and uterus), and a diuretic as well as to treat menstrual hemorrhage, rheumatism, and eczema.

Many studies have assessed the biological activity of U. dioica, reporting antioxidant, antidiabetic, antiviral, [liver protective], antimicrobial, diuretic, anti-inflammatory, anti-hyperlipidemic (lowers the levels of fatty molecules), [antiparasitic], analgesic, anti-arthritic, anti-cancer, hypotensive (lowers blood pressure), and immunomodulatory activities,” they added.

In this study, a team of investigators from the Gazi University in Turkey evaluated the effects of U. dioica in the treatment of endometriosis, using a rat model of disease.

They started by inducing endometriosis in the animals by injecting womb cells from female rat donors into the abdominal walls of other female rats. Then they collected plant extracts containing chemical compounds found on the aerial parts of U. dioica, using three different reagents: methanol, ethyl acetate, and n-hexane.

In addition, in an attempt to isolate the specific compounds that might have relevant clinical activity, they used a technique called chromatography to obtain four different fractions (A, B, C, and D), each containing chemical compounds of different “weights,” found on plant extracts that had been obtained using methanol.

To assess the activity and effects of the different types of extracts and fractions, they then treated animals who had developed endometriosis with the different compounds, all administered orally, once a day, for four weeks, at a dose of 100 mg/kg.

In addition, some animals were treated with buserelin acetate (sold under the brand name Suprefact by Sanofi) — a medication to treat endometriosis — to be used as reference controls.

Results showed that animals treated with methanol plant extracts and those treated with buserelin acetate had a significant reduction in the size of endometrial lesions, compared to rats that had been treated with carboxymethyl cellulose (CMC; controls).

In addition, treatment with methanol plant extracts and with buserelin acetate significantly reduced the levels of two inflammatory markers — tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) — and those of a molecule that controls blood vessel growth, called vascular endothelial growth factor (VEGF), found on the fluid surrounding the lesions.

Analysis of the different fractions that had been obtained from methanol plant extracts revealed fraction C was the most active, having practically the same effects as the original extract at reducing the size of endometrial lesions and the levels of disease activity markers.

A subsequent analysis showed that fraction C contained six different compounds, all belonging to a class of chemicals known as flavonoids: rutin, isoquercetin, kaempferol-3-O-rutinoside, isorhamnetin-3-O-rutinoside, kaempferol-3-O-glucoside and isorhamnetin-3-O-glucoside. Flavonoids are natural substances found in plants and are known for their anti-oxidative, anti-inflammatory and anti-cancer properties.

Flavonoids act as antioxidants, arrest the cell cycle and some of them have been shown to decrease cytokine expression and secretion release,” the researchers said. Cytokines are molecules that mediate and regulate immune and inflammatory responses.

Therefore, flavonoids as cytokine modulators can be effective in the regression of endometriosis,” they concluded.

Read more: https://www.sciencedirect.com/science/article/pii/S0378874118326138?via%3Dihub

After 40 weeks of pregnancy, risk of stillbirth rises

After 40 weeks of pregnancy, risk of stillbirth rises

When pregnancies last for 40 weeks or longer, there is a significant additional risk of stillbirth and neonatal death, according to the results of a large review of studies.

The meta-analysis also found that prolonging pregnancy beyond 40 weeks did not reduce the risk for death in the baby’s first month of life (neonatal mortality).

Prolongation of pregnancy at term is a known risk factor for stillbirth. Currently women are routinely offered induction of labour after 41 weeks gestation to avoid stillbirth. But 1 in 3 stillbirths will happen prior to this gestational age.

The review, published in PLOS Medicine, combined data from 13 studies of stillbirth and neonatal death involving more than 15 million pregnancies.

The researchers found that stillbirths steadily rose with gestational age, from 0.11 per thousand births at 37 weeks to 3.18 per thousand at 42 weeks.

In mothers who continued their pregnancy to 41 weeks, there was a 64% increase in the risk of stillbirth compared to those who delivered at 40 weeks, with 1 additional mother having a stillborn baby for every 1,449 women.

Women need to be aware that there is a small but increasing risk after 40 weeks of gestation,” said the senior author, Shakila Thangaratinam, a professor at Queen Mary University of London. “But induction is a medical procedure that some mothers won’t want. We have to give mothers the information that empowers them to make a decision. We want to promote joint decision making between mother and doctor.”

Read more: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002838


How does endometriosis disrupt sleep?

How does endometriosis disrupt sleep?

Women who suffer from endometriosis often find it difficult to sleep. There are many factors relating to endometriosis and its symptoms that can disturb sleep patterns:

Pain and discomfort

Most women with endometriosis report moderate to severe pelvic pain that increases before and during their period, as well as during and after sex. This pain is associated with endometrial inflammation.

A painful night can affect your sleep. Pain is the most debilitating symptom on a daily basis for many women with endometriosis, and the associated sleep loss can exacerbate that pain even further.

Hot flashes

Women with endometriosis sometimes experience symptoms similar to the uncomfortable hot flashes often associated with menopause. This is believed to be caused by hormone fluctuations or as a side effect of medications commonly used to treat endometriosis.

Hot flashes cause a corresponding surge in adrenaline and are associated with chronic sleep loss.


Women with endometriosis experience higher rates of depression and anxiety than women who suffer from any other gynecological disorder. Chronic pelvic pain and infertility exacerbate anxiety.

Anxiety activates our fight-or-flight response, ramping up the areas of our brain that helps with sleep regulation. This often contributes to a feedback loop, in which people struggling with anxiety and insomnia suffer from chronic worry about not being able to fall asleep, leading to a domino effect that creates a pattern of sleep loss.

Having to go to the bathroom at night

Endometriosis is associated with a range of bladder and bowel symptoms, including frequent urination. This is because, in women with endometriosis, cells that should be in the womb end up elsewhere–like in the bladder or bowels. The body sometimes responds with negative symptoms like an overactive bladder.

Frequent urination during the night disrupts sleep and some women may have trouble falling back asleep due to pain or other troubling symptoms.


Women with endometriosis are likelier to experience migraines. Migraine sufferers are 2 to 8 times likelier to experience sleep problems, according to the American Migraine Association.

Longer and heavier periods

Endometriosis causes longer periods, shorter and more frequent cycles, and heavier menstrual flows for many women. It can also worsen PMS symptoms, from cramps to headaches and bowel-related issues, all of which can disturb sleep.

Because the hormone fluctuations associated with monthly cycles sometimes lead to sleep disturbances, including both hypersomnia and insomnia, it makes sense that women with atypically long periods would experience severe sleep disruption.

Estrogen dominance and deregulation of cortisol

Estrogen dominance as a common imbalance for women with endometriosis and insomnia is a symptom of this. Balanced blood sugar is a key way to manage our hormones. Sleep deprivation negatively affects our blood sugar by causing heightened insulin resistance resulting in higher blood sugar levels. This imbalance causes a cascade of imbalances in the body, including with our hormones.

Perhaps the chronic stress of living with endometriosis is causing cortisol deregulation, which in turn can cause insomnia, disturbed sleep, and a host of other problems that may sound familiar.

Cortisol follows a pattern throughout the day that allows our body to wake up feeling alert, and then unwind, and fall asleep. If this pattern is disturbed, we may find it difficult to wake up or fall asleep, or we may just feel tired all day long.


Levels of thyroid hormones affect chronic pain and severity of endometriosis

Levels of thyroid hormones affect chronic pain and severity of endometriosis

Endometriosis patients with thyroid dysfunction may have increased risk of more intense chronic pain and increased disease severity, a study suggests.

The underlying disease mechanism of endometriosis is still unclear.

Autoimmune thyroid disorders are associated with endometriosis, but the mechanism by which the two diseases are linked is unknown.

Each cell in the body carries protein markers called antigens that allow a cell to be identified as “self” or “non-self” by the immune system. In autoimmune thyroid disorders, the body’s own immune system attacks and damages the thyroid gland. These diseases are characterized by the production of autoantibodies against thyroid-specific antigens, including the thyroid itself and the thyroid-stimulating hormone receptor.

Now, researchers at the Université Paris Descartes looked at the relationship between endometriosis and autoimmune thyroid disorders, specifically at how thyroid disorders affect the progression of endometriosis.

They first found that both the levels of RNA and proteins involved in thyroid metabolism were altered in the biopsied endometrium of patients with endometriosis compared to healthy people. RNA molecules act as templates to make proteins, which perform key functions in the cell.

Moreover, in endometriotic cells, the amount of thyroid hormones was altered compared to that of control cells. The thyroid hormone T4 (thyroxine) is converted into T3 (triiodothyronine), which is much more active than T4. In the endometriotic cells, T4 production was increased while that of T3 was reduced.

The thyroid-stimulating hormone regulates the production of T3 and T4. In vitro (lab) studies using cells from the endometrium of endometriotic patients and healthy controls showed that thyroid-stimulating hormone increased cells’ proliferation. But the researchers saw no differences in the increase of proliferation rate between endometriotic cells and control cells.

Mouse studies confirmed the data gained in vitro since endometriotic implants were found to be bigger when thyroid hormones increased. A retrospective analysis of endometriosis patients with or without a thyroid disorder revealed an increased chronic pelvic pain and disease score in endometriotic patients with a thyroid disorder.

The study, “Role of thyroid dysimmunity and thyroid hormones in endometriosis” was published in the journal PNAS

Read more: https://www.pnas.org/content/116/24/11894

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