Endometriosis of the retrocervical septum is proposed to replace the anatomically incorrect term endometriosis of the rectovaginal septum.

We propose that the term retrocervical septum be added to the medical lexicon to designate the anatomic location of endometriosis of the septum that separates the vagina and posterior vaginal fornix from the rectovaginal pouch of Douglas. Use of the terms retrocervical septum and endometriosis of the retrocervical septum would correct the century-long misuse of the anatomically incorrect term, endometriosis of the rectovaginal septum.

Müllerianosis: four developmental (embryonic) mullerian diseases.

The theory of müllerianosis predicts that embryonic müllerian tissue, misplaced during organogenesis, results in the formation of 4 benign müllerian diseases-developmental adenomyosis, endometriosis, endosalpingiosis, and endocervicosis-(developmental müllerian diseases) that will be identified in human female fetuses, infants, children, adolescents, and adults. Direct evidence is presented to support the existence of developmental adenomyosis, developmental endometriosis, and developmental endocervicosis in human female fetuses along with strong circumstantial evidence supporting the existence of all 4 developmental müllerian diseases in human female infants, children, adolescents, and adults. This evidence throws light upon the pathogenesis of rare müllerian lesions whose pathogenesis remains inexplicable by classical and modern theories. Furthermore, this research has scientific and clinical relevance: scientific relevance because it opens up a new field of comparative research-the 4 developmental müllerian diseases complement the 4 acquired müllerian diseases; clinical relevance because it identifies rare müllerian diseases curable by complete surgical excision.

Pathogenesis of mediastinal paravertebral müllerian cysts of Hattori: developmental endosalpingiosis-müllerianosis.

Hattori reported isolated posterior mediastinal paravertebral müllerian cysts of undetermined pathogenesis in women. We report a 41-year-old woman with a family history of anencephaly, spina bifida, and scoliosis who presented with increasing left-sided mid-thoracic pain uncontrolled by her usual pain medication for symptomatic moderate rotary scoliosis. A magnetic resonance imaging demonstrated a paravertebral saccular lesion at the level of the sixth thoracic vertebra. The 2.1×1.5×1.3 cm T6 paravertebral cyst was excised through a left thoracotomy. The final microscopic diagnosis and immunohistochemistry revealed endosalpingiosis. On the basis of histology, immunohistochemical staining characteristics, and the presence of estrogen and progesterone receptors, we conclude that our patient with a benign mediastinal paravertebral endosalpingiotic müllerian cyst had a lesion identical to those described by Hattori, Thomas-de-Montpreville and Dulmet, and Businger et al. We explain the pathogenesis and thoracic location of posterior mediastinal endosalpingiotic cysts by Ludwig's theory of pathogenesis for the Mayer-Rokitansky-Küster-Hauser syndrome.

The elephant in the room: quality control of endometriosis data.

With the steadily increasing volume of endometriosis articles, and titles and abstracts readily available online, there is a growing risk that references are cited without the full articles having been read by the author(s) or by referees. Too often the titles and statements in abstracts are not supported by data in the published articles. Therefore, the peer-review process should direct extra attention to titles and abstracts to ensure that they are supported by data in the manuscript. Moreover, it is suggested that authors explicitly indicate which references have been read in full. To support the secondary peer-review process, we urge open-access journals to welcome letters to the editor and publish them instead of quietly "burying" them on the Internet.

Peritoneal fluid flow influences anatomical distribution of endometriotic lesions: why Sampson seems to be right.

Endometriosis is a frequent pathology for which the dominant signs and symptoms are pelvic pain and infertility. The physiopathology remains the subject of controversy. Four physiopathological hypotheses have been put forward: regurgitation, metaplasia, induction and (vascular and lymphatic) embolization. The anatomical distribution of endometriotic lesions would appear to be fundamental for a better understanding of Sampson's menstrual regurgitation theory of endometriosis. Analysis of the results in the literature and comparison with our experience clearly shows that the distribution of endometriotic lesions is asymmetrical in several respects. Abdominopelvic anatomy and peritoneal fluid flow can explain this asymmetrical distribution of endometriotic lesions in the great majority of cases. These observations are a very strong argument in favour of the crucial role played by tubal regurgitation and the peritoneal fluid in the physiopathology of endometriosis. The similarity in anatomical distribution of endometriomas, superficial and deeply invasive endometriotic lesions would tend to indicate a common origin for these different types of lesions.

Estradiol production during controlled ovarian hyperstimulation correlates with treatment outcome in women undergoing in vitro fertilization-embryo transfer.

OBJECTIVE: To study the value of E(2) production during controlled ovarian hyperstimulation (COH) in predicting IVF-ET outcome. DESIGN: Historical cohort. SETTING: Academic infertility center. PATIENT(S): A cohort of 270 patients who completed 324 consecutive IVF-ET treatment cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Area under the curve for E(2) levels (AUC-E(2)) from the first day of COH until the day of hCG administration was calculated and cycles grouped into low, average, and high AUC-E(2) groups. Clinical pregnancy rates per cycle were compared among the three groups, and correlations with AUC-E(2) values were calculated for all patients and after sub-grouping according to age, COH protocol and infertility diagnosis. RESULT(S): Cycles with low and high AUC-E(2) values had significantly lower pregnancy rates particularly in patients 35 years or older. There was a positive correlation between AUC-E(2) and pregnancy rates up to a certain AUC-E(2) level above which a negative correlation was found. The turning point between positive and negative correlations occurred at a significantly lower AUC-E(2) level in patients 35 years or older. CONCLUSIONS: Estradiol production during COH correlates with IVF-ET outcome. Women >35 years of age seem more vulnerable to high E(2) levels.