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Quality of data was analyzed by experienced experts including gynecologist and basic scientists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Uterus is a highly vascularized organ, which makes endometrial cells constantly expose to high concentration of oxygen. When endometrial tissues shed off from the eutopic uterus and retrograde to the peritoneal cavity, they face severe hypoxic stress. Even with successful implantation to ovaries or peritoneum, the hypoxic stress remains as a critical issue because endometrial cells are used to live in the well\u2010oxygenated environment. Under the hypoxia condition, cells undergo epigenetic modulation and evolve several survival processes including steroidogenesis, angiogenesis, inflammation and metabolic switch. The complex gene regulatory network driven by hypoxia ensures endometriotic cells can survive under the hostile peritoneal microenvironment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hypoxia plays critical roles in promoting pathological processes to facilitate the development of endometriosis. Targeting hypoxia\u2010mediated gene network represents an alternative approach for the treatment of endometriosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13900","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T03:31:45Z","timestamp":1547004705000},"page":"532-541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Hypoxia: The force of endometriosis"],"prefix":"10.1111","volume":"45","author":[{"given":"Meng\u2010Hsing","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuei\u2010Yang","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Institute of Biochemistry National Chung Hsing University  Taichung 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