{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:29:04Z","timestamp":1791271744119,"version":"4.1.0"},"reference-count":271,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gynecol Obstet Invest"],"abstract":"<jats:p>Background: No conceptually new drugs for the safe and successful cure of endometriosis are likely to become available soon. Hormonal modulation of ovarian function and suppression of menstruation remain the pillars of disease control. However, existing drugs may be used following novel modalities to limit the consequences of endometriosis progression. Objectives: The aims of this review were to propose a pharmacological approach aimed at limiting the potential detrimental effects of the recent dramatic increase in postmenarcheal repetitive ovulatory menses and to define the type of hormones and the routes of administration that can be used to maximize safety and tolerability in the medical treatment of endometriosis. Methods: For this narrative review, we selected the best quality evidence, prioritizing RCTs, systematic reviews, meta-analyses, network meta-analyses, and international guidelines, preferably published in the last decade. Outcome: Medical treatment of endometriosis should be included into all aspects of prevention. Very-low-dose combined oral contraceptives can be used for years to counteract the increased risk of ovarian cancer observed in patients with endometriosis. This primary prevention measure saves lives and can effectively integrate targeted risk-reducing surgery. Secondary pharmacological prevention, based on a working diagnosis of early onset adenomyosis-endometriosis selectively in adolescents with severe dysmenorrhea and heavy menstrual bleeding, can potentially impede the development of advanced disease forms, and reduce the need for management of complications due to a delay in diagnosis and treatment. Tertiary prevention, i.e., medical therapy of established disease, is based initially on the safest available estrogen-progestogen combinations and progestogen monotherapies. Whenever possible, ethinyl estradiol and cyproterone acetate should be avoided because of thromboembolic and meningioma risks, respectively. Estradiol can be administered transdermally. Switching to gonadotropin-releasing hormone agonists and antagonists should not be delayed when the first-line agents fail. Conclusions and Outlook: Two-thirds of symptomatic endometriosis patients can be managed satisfactorily for many years using, with the right modality, the existing safe, effective, and well-tolerated medications. Despite the constant plea for new drugs, this already appears to be an excellent clinical outcome, unsurpassed when managing other human chronic inflammatory diseases. Cohort studies are needed to verify whether turning off the recurrent inflammation caused by repeated ovulation and menstruation could also affect the risk of systemic conditions associated with endometriosis.<\/jats:p>","DOI":"10.1159\/000542947","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T12:00:23Z","timestamp":1735214423000},"page":"535-559","source":"Crossref","is-referenced-by-count":18,"title":["Update on Medical Treatment of Endometriosis: New Drugs or New Therapeutic Approaches?"],"prefix":"10.1159","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-0996","authenticated-orcid":false,"given":"Paolo","family":"Vercellini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Buffo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Vigan\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgardo","family":"Somigliana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.05.004"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2018.1461840"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey015"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.03.012"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2018.1550576"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoz040"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead061"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02647-y"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.52054\/FVVO.15.3.090"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000084"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0245-z"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1810764"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2020.101798"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.04.041"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00389-5"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2022.102311"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070750"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-021-09666-w"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.220637"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000983"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.08.019"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2023.03.006"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s10397-011-0723-3"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.03.004"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.07.013"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000003218"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-024-00966-8"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2023.1306380"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101596"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac009"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-020-00305-9"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11102618"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.yhbeh.2016.11.012"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1093\/emph\/eoab008"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1037\/ebs0000275"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1994.tb30427.x"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2001.0876"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12694"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deac156"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2023.103696"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2023.103695"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead229"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmac014"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01640-4"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00550-6"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)11159-0"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1002\/bies.201190071"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1016\/s0889-8545(02)00050-5"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2004.01.007"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2016.04.021"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06541-0"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.10.857"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-012-9963-4"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3778"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2022.0126"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00075"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gaab036"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9020485"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1530\/REP-22-0224"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1718920"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2024.104345"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoae045"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.02.103"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.2741\/e358"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.07.1075"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-020-00164-z"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad033"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2015.03.004"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dex354"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2019.11.011"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/4.5.752"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06597-y"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14834"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.12.004"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.12.039"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2023.103768"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-5276.20.05842-9"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.xfnr.2024.100083"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199303000-00009"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-007-0479-1"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2012.05.035"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.06.001"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000142714.54857.f8"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-023-00332-0"},{"key":"ref85","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20222"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoae036"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02055.x"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoae035"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2024.155353"},{"key":"ref90","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(97)70482-4"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.019"},{"key":"ref92","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead206"},{"key":"ref93","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-02122-0"},{"key":"ref94","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2024.2317295"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7304a1"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000212"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2016.1121991"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.09.037"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.01.003"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.1016\/s0010-7824(00)00182-7"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa186"},{"key":"ref102","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.03.023"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2016.12.002"},{"key":"ref104","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.02.034"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.2165\/11598050-000000000-00000"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.769187"},{"key":"ref107","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2023.110310"},{"key":"ref108","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110727"},{"key":"ref109","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6423"},{"key":"ref110","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5298"},{"key":"ref111","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2021.1987410"},{"key":"ref112","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12036"},{"key":"ref113","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3641-1"},{"key":"ref114","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2017-200036"},{"key":"ref115","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-074450"},{"key":"ref116","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14384"},{"key":"ref117","doi-asserted-by":"publisher","DOI":"10.1080\/17446651.2019.1604217"},{"key":"ref118","doi-asserted-by":"publisher","DOI":"10.1177\/10760296241286514"},{"key":"ref119","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-022-01737-7"},{"key":"ref120","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01738-8"},{"key":"ref121","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2023.100266"},{"key":"ref122","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurox.2024.100283"},{"key":"ref123","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.07.011"},{"key":"ref124","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.11.015"},{"key":"ref125","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-2237"},{"key":"ref126","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmy039"},{"key":"ref127","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06647-5"},{"key":"ref128","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14066-4"},{"key":"ref129","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2135"},{"key":"ref130","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2024.02.003"},{"key":"ref131","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2024.09.004"},{"key":"ref132","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.11.003"},{"key":"ref133","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004896"},{"key":"ref134","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.10.022"},{"key":"ref135","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.01.015"},{"key":"ref136","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2017.03.033"},{"key":"ref137","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0044"},{"key":"ref138","doi-asserted-by":"publisher","DOI":"10.1177\/1933719112438061"},{"key":"ref139","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200619"},{"key":"ref140","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2016.22.5.573"},{"key":"ref141","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.67023"},{"key":"ref142","doi-asserted-by":"publisher","DOI":"10.1177\/0091270011423664"},{"key":"ref143","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.11.016"},{"key":"ref144","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.12.024"},{"key":"ref145","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-023-07271-7"},{"key":"ref146","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3681-6"},{"key":"ref147","doi-asserted-by":"publisher","DOI":"10.1186\/s40360-024-00767-1"},{"key":"ref148","doi-asserted-by":"publisher","DOI":"10.1159\/000529185"},{"key":"ref149","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.10.014"},{"key":"ref150","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2022.1013921"},{"key":"ref151","doi-asserted-by":"publisher","DOI":"10.1080\/03630242.2024.2382418"},{"key":"ref152","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.02.008"},{"key":"ref153","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004899"},{"key":"ref154","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13798"},{"key":"ref155","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.21471"},{"key":"ref156","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100813"},{"key":"ref157","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2018.07.003"},{"key":"ref158","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2022.2031144"},{"key":"ref159","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2014.888414"},{"key":"ref160","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-079006"},{"key":"ref161","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e2990"},{"key":"ref162","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.01.071"},{"key":"ref163","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210089"},{"key":"ref164","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.08.038"},{"key":"ref165","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100928"},{"key":"ref166","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15423"},{"key":"ref167","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-078078"},{"key":"ref168","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-022-04124-2"},{"key":"ref169","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.12.001"},{"key":"ref170","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2018.1541080"},{"key":"ref171","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2022.2114792"},{"key":"ref172","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.05.002"},{"key":"ref173","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2022.08.856"},{"key":"ref174","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06862-0"},{"key":"ref175","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.06.009"},{"key":"ref176","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.11.013"},{"key":"ref177","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S442357"},{"key":"ref178","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2020.1789591"},{"key":"ref179","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2024.104321"},{"key":"ref180","doi-asserted-by":"publisher","DOI":"10.1002\/cpdd.640"},{"key":"ref181","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-019-00840-7"},{"key":"ref182","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.1689"},{"key":"ref183","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dead263"},{"key":"ref184","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae076"},{"key":"ref185","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.06.040"},{"key":"ref186","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz086"},{"key":"ref187","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2021.2022644"},{"key":"ref188","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoad008"},{"key":"ref189","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2005.12.030"},{"key":"ref190","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt016"},{"key":"ref191","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2020.07.011"},{"key":"ref192","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.06.012"},{"key":"ref193","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005448"},{"key":"ref194","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2010.08.002"},{"key":"ref195","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2021.1878134"},{"key":"ref196","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15572"},{"key":"ref197","doi-asserted-by":"publisher","DOI":"10.52054\/FVVO.13.3.028"},{"key":"ref198","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae180"},{"key":"ref199","doi-asserted-by":"publisher","DOI":"10.1159\/000452098"},{"key":"ref200","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae125"},{"key":"ref201","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2020-0539"},{"key":"ref202","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae290"},{"key":"ref203","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2016.02.008"},{"key":"ref204","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2023.05.001"},{"key":"ref205","doi-asserted-by":"publisher","DOI":"10.1093\/sexmed\/qfae049"},{"key":"ref206","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14887"},{"key":"ref207","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005444"},{"key":"ref208","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2024.01.002"},{"key":"ref209","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2024.03.032"},{"key":"ref210","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2021.11.024"},{"key":"ref211","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmp007"},{"key":"ref212","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.07.033"},{"key":"ref213","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa033"},{"key":"ref214","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2020.05.007"},{"key":"ref215","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-023-01266-0"},{"key":"ref216","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2020.09.018"},{"key":"ref217","doi-asserted-by":"publisher","DOI":"10.1177\/17455057241252573"},{"key":"ref218","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae257"},{"key":"ref219","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2024.09.050"},{"key":"ref220","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70404-1"},{"key":"ref221","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa045"},{"key":"ref222","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.9210"},{"key":"ref223","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.12357"},{"key":"ref224","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2024.2974"},{"key":"ref225","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2022.04.001"},{"key":"ref226","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000217"},{"key":"ref227","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60167-1"},{"key":"ref228","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318291c235"},{"key":"ref229","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw306"},{"key":"ref230","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k3609"},{"key":"ref231","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.12.007"},{"key":"ref232","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.03.035"},{"key":"ref233","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(08)60139-7"},{"key":"ref234","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2023.113350"},{"key":"ref235","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31010032"},{"key":"ref236","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2024.109680"},{"key":"ref237","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.05.011"},{"key":"ref238","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1709636"},{"key":"ref239","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.12.022"},{"key":"ref240","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2021.729601"},{"key":"ref241","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.12.008"},{"key":"ref242","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m200"},{"key":"ref243","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.03.012"},{"key":"ref244","doi-asserted-by":"publisher","DOI":"10.1159\/000539515"},{"key":"ref245","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111906"},{"key":"ref246","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.64"},{"key":"ref247","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.17028"},{"key":"ref248","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2017.1422239"},{"key":"ref249","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200658"},{"key":"ref250","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.2387"},{"key":"ref251","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2023.101111"},{"key":"ref252","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.2838"},{"key":"ref253","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.51214"},{"key":"ref254","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l335"},{"key":"ref255","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.10.002"},{"key":"ref256","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-019-1034-z"},{"key":"ref257","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14014"},{"key":"ref258","doi-asserted-by":"publisher","DOI":"10.1093\/sxmrev\/qeae011"},{"key":"ref259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2019.08.005"},{"key":"ref260","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2015.5703"},{"key":"ref261","doi-asserted-by":"publisher","DOI":"10.1530\/EC-18-0384"},{"key":"ref262","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12310"},{"key":"ref263","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.08.057"},{"key":"ref264","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2009.06.017"},{"key":"ref265","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-023-02490-1"},{"key":"ref266","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00802-X"},{"key":"ref267","doi-asserted-by":"publisher","DOI":"10.1159\/000358392"},{"key":"ref268","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2024.102500"},{"key":"ref269","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.p2043"},{"key":"ref270","doi-asserted-by":"publisher","DOI":"10.1007\/s00439-023-02582-w"},{"key":"ref271","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2024.104292"}],"container-title":["Gynecologic and Obstetric Investigation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/goi\/article-pdf\/doi\/10.1159\/000542947\/4318938\/000542947.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000542947","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T17:11:08Z","timestamp":1764609068000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000542947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":271,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12,1]]},"published-print":{"date-parts":[[2025,12,4]]}},"URL":"https:\/\/doi.org\/10.1159\/000542947","archive":["Portico"],"relation":{},"ISSN":["0378-7346","1423-002X"],"issn-type":[{"value":"0378-7346","type":"print"},{"value":"1423-002X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,26]]}}}