Microbiome & Endometriosis

Abstract

Endometriosis is a chronic disease of the female reproductive system, which is characterised by the presence of endometrial tissue outside the uterus especially in the pelvic cavity that includes ovaries, fallopian tubes and it may occur extra genitally in some rare cases. 176 million women all over the world including 26 million in India suffer from endometriosis and high frequency was observed between the age group of 26-30 years, resulting in increased primary infertility. Various studies surveying the female reproductive tract have confirmed the existence of microbiota starting in the vagina, cervix, uterus, fallopian tubes and ovaries. These microbes play a crucial role at different stages ofthe reproduction, in forming a physical barrier against pathogen and the stimulation of host defence mechanisms. Direct and indirect mechanisms are observed including the production of biochemically active compounds that directly kill or inhibit pathogens. Women suffering from endometriosis lead an impaired quality of life and continue to deal with endometriosis-associated symptoms even after diagnosis and treatment of the disease. In endometriosis condition, adhesions are observed in the fallopian tubes and ovaries that block tubal motility and damage the oocyte-pickup. Progesterone resistance is familiar in endometriosis which changes the implantation window period causing the loss of implantation markers and finally leading to infertility. Malignant tumours of ovaries have also been identified and known to arise from endometriosis. Microbiome can be used as a novel diagnostic tool for endometriosis as there is a variation observed in the composition and distribution along the female reproductive tract of healthy women and endometriosis patients. A non-invasive diagnosis is achieved through this, aiming at early diagnosis and alternative treatment for endometriosis.