The ENDO Study is a collaborative epidemiologic study whose goal is to assess the relation between exposure to environmental chemicals and lifestyle factors that may affect womens reproductive health. Both persistent and non-persistent chemicals are being assessed in relation to the odds of an incident diagnosis of endometriosis. Endometriosis is a condition in which endometrial tissue is found outside the uterus and can be associated with pelvic pain, menstrual changes and infertility. Approximately 11% of women aged 18-44 years may be affected, and many cases may be currently undetected. To date, the cause of endometriosis is unknown and, increasingly, an environmental etiology is suspected for some affected women. A matched cohort design was utilized to establish two cohorts of women - operative and population. 495 women were recruited from 14 participating clinics located in the San Francisco and Salt Lake City areas. This operative cohort was matched on age and residence with a 50-mile catchment area of participating clinical centers to establish a population cohort comprising 131 women who underwent pelvic MRIs to identify endometriosis or its absence. Women participated in baseline interviews and provided blood and urine samples priort to surgery or MRI. Additional operative biospecimens were obtained from the operative cohort when available (i.e., omentum fat, peritoneal fluid, endometrial implants). Serum, fat and urine samples have undergone toxicologic analysis for the quantification of persistent and short lived chemical exposures to assess their relation with endometriosis and, eventually, other gynecologic conditions such as fibroids. A number of persistent and short lived environmental chemicals have been associated with endometriosis. However, the findings vary by method of diagnosing endometriosis (for example by surgical or MRI visualization).

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Schliep, K C; Chen, Z; Stanford, J B et al. (2017) Endometriosis diagnosis and staging by operating surgeon and expert review using multiple diagnostic tools: an inter-rater agreement study. BJOG 124:220-229
Schliep, K C; Mumford, Sunni L; Johnstone, Erica B et al. (2016) Sexual and physical abuse and gynecologic disorders. Hum Reprod 31:1904-12
Buck Louis, Germaine M; Backonja, Uba; Schliep, Karen C et al. (2016) Women's Reproductive History Before the Diagnosis of Incident Endometriosis. J Womens Health (Larchmt) 25:1021-1029
Backonja, Uba; Buck Louis, Germaine M; Lauver, Diane R (2016) Overall Adiposity, Adipose Tissue Distribution, and Endometriosis: A Systematic Review. Nurs Res 65:151-66
Johnstone, Erica B; Louis, Germaine M Buck; Parsons, Patrick J et al. (2014) Increased urinary cobalt and whole blood concentrations of cadmium and lead in women with uterine leiomyomata: Findings from the ENDO Study. Reprod Toxicol 49:27-32
Pollack, Anna Z; Louis, Germaine M Buck; Chen, Zhen et al. (2013) Trace elements and endometriosis: the ENDO study. Reprod Toxicol 42:41-8
Buck Louis, Germaine M; Peterson, C Matthew; Chen, Zhen et al. (2013) Bisphenol A and phthalates and endometriosis: the Endometriosis: Natural History, Diagnosis and Outcomes Study. Fertil Steril 100:162-9.e1-2
Wolff, Erin Foran; Sun, Liping; Hediger, Mary L et al. (2013) In utero exposures and endometriosis: the Endometriosis, Natural History, Disease, Outcome (ENDO) Study. Fertil Steril 99:790-5
Peterson, C Matthew; Johnstone, Erica B; Hammoud, Ahmad O et al. (2013) Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am J Obstet Gynecol 208:451.e1-11
Buck Louis, Germaine M; Hediger, Mary L; Peterson, C Matthew et al. (2011) Incidence of endometriosis by study population and diagnostic method: the ENDO study. Fertil Steril 96:360-5

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