{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:08:04Z","timestamp":1790744884235,"version":"4.1.0"},"reference-count":87,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Peritoneal fluid in ovulatory women is an ovarian exudate with higher estrogen and progesterone concentrations than in plasma. In the follicular phase, progesterone concentrations are as high as plasma concentrations in the luteal phase. After ovulation, estrogen and progesterone concentrations in the peritoneal fluid are 5\u201310 times higher than in plasma, both in women with and without endometriosis. The histologically proliferative aspect without secretory changes of most superficial subtle lesions is not compatible with the progesterone concentrations in the peritoneal fluid. Therefore, we have to postulate a strong progesterone resistance in these lesions. The mechanism is unclear and might be a peritoneal fluid effect in women with predisposing defects in the endometrium, or isolated endometrial glands with progesterone resistance, or subtle lesions originating from the basal endometrium: the latter hypothesis is attractive since in basal endometrium progesterone does not induce secretory changes while progesterone withdrawal, not occurring in peritoneal fluid, is required to resume mitotic activity and proliferation. Hormone concentrations in the peritoneal fluid are an important factor in understanding the medical therapy of endometriosis. The effect of oestro-progestin therapy on superficial endometriosis lesions seems to be a consequence of the decreased estrogen concentrations rather than a direct progestin effect. In conclusion, the peritoneal fluid, being a secretion product of the ovarian follicule, deserves more attention in the pathophysiology and treatment of endometriosis.<\/jats:p>","DOI":"10.1093\/humrep\/deab258","type":"journal-article","created":{"date-parts":[[2021,11,5]],"date-time":"2021-11-05T12:22:44Z","timestamp":1636114964000},"source":"Crossref","is-referenced-by-count":8,"title":["Peritoneal fluid progesterone and progesterone resistance in superficial endometriosis lesions"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2929-0967","authenticated-orcid":false,"given":"Philippe R","family":"Koninckx","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Latifa Hospital, Dubai, United Arab Emirates"},{"name":"Prof Emeritus OBGYN, KULeuven, Leuven, Belgium"},{"name":"University of Oxford-Hon Consultant, Obstetrics and Gynaecology, Oxford, UK"},{"name":"Gemelli hospitals, Obstetrics and Gynecology, University Cattolica, Roma, Italy"},{"name":"Moscow State University, Obstetrics and gynecology, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Ussia","sequence":"additional","affiliation":[{"name":"Gemelli hospitals, Obstetrics and Gynecology, University Cattolica, Roma, Italy"},{"name":"Gruppo Italo Belga, Obstetrics and Gynecology, Villa Del Rosario Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Adamyan","sequence":"additional","affiliation":[{"name":"Department of Operative Gynecology, Federal State Budget Institution V. 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Kulakov Research Centre for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia; Department of Reproductive Medicine and Surgery, Moscow State University of Medicine and Dentistry, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Gomel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of British Columbia, Women's Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1904-1449","authenticated-orcid":false,"given":"Dan C","family":"Martin","sequence":"additional","affiliation":[{"name":"Professor Emeritus, University of Tennessee Health Science Centre, Memphis, TN, USA"},{"name":"Institutional Review Board, Virginia Commonwealth University, Richmond, VA, 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