Endometriosis Institute Research staff has conducted studies on endometriosis for more than 30 years.   Dr. Dmowski's first publications and his Ph.D. research dealing with hormonal management of endometriosis date back to 1967.   He was instrumental in the development and clinical application of danazol (Danocrine), a drug of remarkable properties still used in the management of endometriosis.  Subsequently, our staff have participated in the development and evaluation of several GnRH agonists, such as Lupron, Depot Lupron, Buserelin, Synarel, and Zoladex, which currently represent a mainstay in the medical management of endometriosis.

In 1981, Dr. Dmowski, in his publication in the American Journal of Obstetrics and Gynecology, was the first to draw attention to changes in cell mediated immunity associated with endometriosis.  Since then, basic research studies at the Endometriosis Institute have concentrated on the relationship between the immune system and endometriosis.  These studies have been conducted in collaboration with Dr. Donald Braun.

We have demonstrated that in women with endometriosis, cell mediated immunity and in particular monocyte-macrophage function is altered.   Additionally, in about 50-60% of affected women, there are changes in humoral immunity in the form of abnormal circulating autoantibodies. We postulate that the alterations in cell mediated immunity interfere with normal elimination of misplaced endometrial cells, leading to the development of the disease.  We propose that these alterations in immune function are transmitted genetically or can be acquired.   Environmental toxins, i.e., organochlorides such as dioxin or polychlorinated biphenyls (PCB's) may play a role in the development of endometriosis through suppression of the normal cell mediated immune response, as was suggested by one of our studies.

At the October 1997 meeting of the American Society for Reproductive Medicine, we reported that programmed cell death (apoptosis) is much lower in the ectopic endometrial cells (endometriosis) than in normal endometrium, which suggests another mechanism for the development of endometriosis.  It is likely that both the immune system dysfunction and the altered cell death play an integral part in the formation of endometriosis implants.  We hope that in the future clarification of the immune deficiency or the nature of increased resistance to apoptosis may lead to a screening test for identification of women susceptible to endometriosis and may allow for the development of cause-directed therapy. Our studies indicate that changes in humoral immunity in endometriosis are secondary to the ectopic growth of the endometrial cells and may contribute to infertility.   Interestingly, our recent clinical studies suggest biological differences between women with endometriosis who have infertility and those who have pelvic pain symptoms.   Furthermore, the average diagnostic delay was twice as long in women with pelvic pain than in those with infertility (6.35 years vs. 3.13 years) suggesting a certain degree of complacency on the part of physicians as well as society in general when it comes to pelvic pain symptoms.

Research Funding.

Endometriosis Institute receives funding and grants for research and clinical studies from federal agencies, private philanthropic organizations, the pharmaceutical industry, and individual donors. 

Current Clinical Researches.

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Selected Bibliography.

The following bibliographical information is provided as a reference source to medical professionals and patients alike, and should be used as a starting point to learn more about endometriosis and its association with infertility its causes and possible treatments.  Additionally, all references provided are for information only and should not replace timely and professional medical care and treatment.  To obtain a copy of the listed source, copy down the authors, title, and journal citation (with page numbers), and give this information to your local librarian.

1. Dmowski W.P., Scholer H.F.L., Mahesh, V.B. and Greenblatt, R.B. Danazol-a synthetic steroid derivative with interesting physiologic properties. Fertil Steril, 22:9, 1971.

2. Greenblatt, R.B., Dmowski, W.P., Mahesh, V.B., and Scholer, H.F.L. Clinical studies with an antigonadotropin- Danazol. Fertil Steril, 22:102, 1971.

3. Dmowski, W.P. Biologic properties of a new steroid compound (danazol) with alleged antigonadotrophic function. Ph.D. dissertation, Medical College of Georgia, Augusta, Georgia, June 1971.

4. Dmowski, W.P. and Cohen, M. Treatment of endometriosis with an antigonadotropin, danazol. A laparoscopic and histologic evaluation. Obstet Gynecol, 46:147, 1975.

5. Sotrel, G. and Dmowski, W.P. Endometriosis and its management. Obstet Gynecol Digest, 18:26, 1976.

6. Dmowski, W.P., and Cohen, M.R. Antigonadotropin (danazol) in the treatment of endometriosis. Evaluation of post-treatment fertility and three year follow-up data. Am J Obstet Gynecol, 130:41, 1978.

7. Dmowski, W.P. Endocrine properties and clinical application of danazol. Fertil Steril, 31:237, 1979.

8. Schweppe, K.W., Dmowski, W.P. and Wynn, R.M. Ultrastructural changes in endometriotic tissue during danazol treatment. Fertil Steril, 36:20, 1981.

9. Dmowski, W.P., Steele, R.W. and Baker G.F. Deficient cellular immunity in endometriosis. Am J Obstet Gynecol, 141:377, 1981.

10. Radwanska, E. and Dmowski, W.P. Luteal function in infertile women with endometriosis. Infertility, 4:269, 1981.

11. Dmowski, W.P., Kapetanakis, E. and Scommegna, A. Variable effects of danazol on endometriosis at 4 low dose levels. Obstet Gynecol, 59:408, 1982.

12. Radwanska, E., Sachdeva, S., and Dmowski, W.P. Effects of danazol on pulsatile prolactin patterns in women with pelvic endometriosis. Acta Endocrinol, 103(supplement 256):270, 1983.

13. Dmowski, W.P., Headley, S., Radwanska, E., Effects of danazol on pulsatile gonadotropin patterns and on serum estradiol levels in normally cycling women.  Fertil Steril, 39:427, 1983.

14. Gleicher N., Dmowski W.P., Siegel I., Liu T.L., Friberg J., Radwanska E., and Toder, V. Lymphocyte subsets in endometriosis.  Obstet Gynecol, 63:463, 1984. 

15. Radwanska E., Rana N., and Dmowski, W.P. Management of infertility in women with endometriosis and ovulatory dysfunction.  Fertil Steril, 41:77s, 1984.

16. Steele R., Dmowski W.P., and Marmer K.J. Immunologic aspects of human endometriosis.  Am J Reprod Immunol, 6:33, 1984.

17. Dmowski W.P., Current concepts in the management of endometriosis.  Acta Obstet Gynecol Scand Suppl 123:29, 1984.

18. Dmowski W.P. Pitfalls in clinical, laparoscopic, and histologic diagnosis of endometriosis.  Acta Obstet Gynecol Scand Suppl, 123:61, 1984.

19. Dmowski W.P. and Radwanska E. Endometriosis and infertility.  Acta Obstet Gynecol Scand. Suppl, 123: 73, 1984.

20. Dmowski W.P., Radwanska E., Binor Z., and Rana N. Mild endometriosis and ovulatory dysfunction: effect of danazol treatment on success of ovulation induction.  Fertil Steril, 46:786, 1986.

21. Dmowski W.P. Visual assessment of peritoneal implants for staging endometriosis: do number and cumulative size of lesions reflect the severity of a systemic disease? Fertil Steril, 47:382, 1987.

22. Dmowski W.P. Danazol-induced pseudomenopause in management of endometriosis. Contr Gynecol Obstet, 16:220, 1987.

23. Dmowski W.P. Immunologic aspects of endometriosis.  Contr Gynecol Obstet, 16:48, 1987.

24. Dmowski W.P.  Management of mild and moderate endometriosis.  Contr Gynecol Obstet, 16:350, 1987.

25. Zeller J.M., Henig I., Radwanska E., Dmowski W.P. Enhancement of human monocyte and peritoneal macrophage chemiluminescence activities in women with endometriosis.  Am J Reprod Immunol Microbiol, 13:78, 1987.

26. Radwanska E., Henig, I., and Dmowski W.P. Nocturnal prolactin levels in infertile women with endometriosis J Reprod Med, 32:8, 1987.

27. Dmowski W.P.  Immunologic aspects of endometriosis. Gynecol Endocrinol, 2(S2):11, 1988.

28. Henig I., Rawlins R.G., Weinrib H.P. and Dmowski W.P.  Effects of danazol, gonadotropin-releasing hormone agonist, and estrogen/progesterone combination on experimental endometriosis in ovariectomized rats. Fertil Steril, 49:349, 1988.

29. Tummon I., Ali A., Pepping M.E., Radwanska E., Binor Z., and Dmowski W.P. Bone mineral density in women with endometriosis before and during ovarian suppression with gonadotropin-releasing hormone agonists or danazol.  Fertil Steril, 49:792, 1988.

30. Dmowski W.P., Rana N., Radwanska E. Recurrent endometriosis following hysterectomy and oophorectomy: the role of residual ovarian fragments.  Int J Gynecol Obstet, 26:93, 1988.

31. Dmowski W.P. Danazol-induced pseudomenopause in the management of endometriosis.  Clin Obstet Gynecol, 31:829,1988.

32. Dmowski W.P., Radwanska E., Binor Z., Pepping P. and Tummon I. GnRH agonists in the management of endometriosis.  Gynecol Endocrinol, 1988.

33. Dmowski W.P. Danazol-a steroid derivative with multiple and diverse biological effects.  Br J Clin Pract, 42:343, 1988.

34. El-Roeiy A., Dmowski W.P., Gleicher N., Radwanska E., Harlow L., Binor Z., and Tummon I. Danazol but not GnRH agonists suppresses autoantibodies in endometriosis.  Fertil Steril, 50:864, 1988.

35. Tummon I., Maclin V., Radwanska E., Binor Z., and Dmowski W.P. Occult ovulatory dysfunction in women with minimal endometriosis or unexplained fertility.  Fertil Steril, 50:716, 1988.

36. Dmowski W.P., Gebel H.M., Rawlins R.G.   Immunologic aspects of endometriosis.  Obstet Gynecol Clin N Amer, 16:93, 1989.

37. Dmowski W.P., Radwanska E., Binor Z., Tummon I., and Pepping P. Ovarian suppression induced with buserelin or danazol in the management of endometriosis; a randomized, comparative study. Fertil Steril, 51:395, 1989.

38. Tummon I.S., Pepping M.E., Binor Z., Radwanska E., Dmowski W.P. A randomized, prospective comparison of endocrine changes induced with intranasal leuprolide or danazol for treatment of endometriosis.   Fertil Steril, 51:390, 1989.

39. Dmowski W.P. Comparative study of buserelin versus danazol in the management of endometriosis.  Gynecol Endocrinol, 3(S2):21, 1989.

40. Dmowski W.P.  Medical treatment of endometriosis.  J SOGC, 11:25, 1989.

41. Dmowski W.P. Danazol: A synthetic steroid with diverse biologic effects. J Reprod Med, 35(S1): 69-74, 1990.

42. Dmowski W.P., Braun D., Gebel H., Endometriosis genetic and immunologic aspects.  Prog Clin Biol Res, 323: 99-122, 1990.

43. Gebel H., Braun D., Rana N., Rotman C., Semino A., Dmowski W.P. Reduced production of immunoglobin  subclasses in patients with endometriosis.  Am J Reprod Immunol 25:59, 1991.

44. Dmowski W.P. Etiology and histogenesis of endometriosis.  Ann NY Acad Sci, 622:236-41, 1991.

45. Braun D.P., Muriana A., Gebel H., Rotman C., Rana N., Dmowski W.P. Stimulation of endometrial cell (EC) proliferation by   peripheral blood monocyte (PBM) from women with endometriosis.  Fertil Steril, S79, 1991.

46. Braun D.P., Gebel H., Rotman C., Rana N., Dmowski W.P. The development of cytotoxicity in peritoneal macrophages from women with endometriosis.  Fertil Steril 57:1203, 1992.

47. Gebel H., Braun D.P., Rotman C., Rana N., and Dmowski W.P. Mitogen induced production of polyclonal IgG is decreased in women with severe endometriosis. Am J Reprod Immunol, 29:124-130, 1993.

48. Braun D.P., Muriana A., Gebel H., Rotman C., Rana N., and Dmowski W.P. Monocyte-mediated enhancement of endometrial cell proliferation in women with endometriosis. Fertil Steril, 61:78-84, 1994.

49. Braun D.P., Gebel H., Dmowski W.P. Effect of Danazol in vitro and in vivo on monocyte-mediated enhancement of endometrial cell proliferation in women with endometriosis. Fertil Steril, 62:89-95, 1994.

50. Dmowski W.P., Gebel H., Braun D.P. The role of cell-mediated immunity in pathogenesis of endometriosis.  Acta Obstet Gynecol Scand, (S) 159:7-14, 1994.

51. Dmowski W.P., Rana N., Michalowska J., Friberg J., Papesirniak C., El-Roeiy A. The effect of endometriosis, its stage and activity, and of autoantibodies on in vitro fertilization/Embryo Transfer Success Rates.   Fertil Steril 63:555-562, 1995.

52. Dmowski W.P. Immunological aspects of endometriosis.  Proceedings of an Official Symposium held at the XIV FIGO World Congress, Montreal Canada, September 29, 1994.  Int J Gynecol Obstet,50:(Suppl. No. 1) S3-S10, 1995.

53. Dmowski W.P.. Endometriosis and In Vitro Fertilization.  Assisted Reproduction Reviews, 5:74-81, 1995.

54. Dmowski W.P., Braun D.P.   Immunological aspects of endometriosis.  Contemp Rev Obstet Gynaecol, 7:167-171, 1995.

55. Gebel, H. Rana N., Braun D.P., Dmowski W.P.  Differential expression of VLAB1 (CD29) on monocytes from patients with endometriosis.  Am J Reprod Immunol, 34:317-322, 1995.

56. Rana N., Thomas S., Rotman C., Dmowski W.P. Decrease in the size of ovarian endometriomas during ovarian suppression in stage IV endometriosis; The role of preoperative medical treatment.  J Reprod Med, 41:384-392, 1996.

57. Rana N., Braun D., House R., Gebel H., Rotman C., Dmowski W.P.  Basal and stimulated secretion of cytokines by peritoneal macrophages in women with endometriosis.  Fertil Steril, 65:925-930, 1996.

58. Braun D., Gebel H., House R., Rana N., Dmowski W.P. Spontaneous and induced synthesis of cytokines  by peripheral blood monocytes in patients with endometriosis.  Fertil Steril, 65:1125-1129, 1996.

59. Rana N., Rotman C., Hasson H., Redwine D.B., Dmowski W.P.  Ovarian remnant syndrome after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for severe pelvic endometriosis.  J Am Assoc Gynecol Laparosc, 3:423-426, 1996.

60. Marshall, L.A., Cain D.F., Dmowski W.P., Chesnut C.H.  Urinary N-telopeptides to monitor bone resorption while on GnRH agonist therapy.  Obstet Gynecol, 87:350-354, 1996

61. Dmowski W.P. Current concepts on the etiology and histogenesis of endometriosis.  References en Gynecologie Obstetique, 4(1):9-18, 1996

62. Dmowski W.P. Rana N., Pepping P., Cain D.F., Clay T.H. Excretion of urinary N-telopeptides reflects changes in bone turnover during ovarian suppression and indicates individually variable estradiol threshold for bone loss.   Fertil Steril,  66: 929-936, 1996.

63. Dmowski W.P., Lesniewicz R., Rana N., Pepping P., Noursalehi M.  Changing trends in the diagnosis of endometriosis;  A comparative study of women with pelvic endometriosis presenting with chronic pelvic pain or infertility.  Fertil Steril, 67: 238-243, 1997.

64. Dmowski W.P., Gebel H., Braun D.P.   Decreased apoptosis and sensitivity to macrophage mediated cytolysis of endometrial cells in endometriosis.  Human Reprod. (submitted).

1. Dmowski, W.P. and Scommegna, A. The rationale for treatment of endometriosis with danazol. In: Recent Advances in Endometriosis, Proceedings of a Symposium, Edited by R.B. Greenblatt. Excerpta Medica, 1976, pp.87.

2. Dmowski, W.P., Cohen, M., and Wilhelm, J. Endometriosis and ovulatory failure. Does it occur? Should ovulatory stimulating agents be used? In: Recent Advances in Endometriosis, Proceedings of a Symposium, Edited by R.B. Greenblatt. Excerpta Medica, 1976, pp.129.

3. Dmowski, W.P. and Scommegna A. The appropriate uses of medical and surgical therapy in endometriosis. In: Reid's Controversy in Obstetrics and Gynecology, Edited by F. Zuspan and C.D. Christian, Third Edition. New York, W.B. Saunders Company, 1983, pp.543-553.

4. Dmowski, W.P. Current concepts in the management of endometriosis.  In: Obstetrics and Gynecology Annual 1981, Edited by R.M.Wynn. New York, Appleton-Century-Crofts, 1981, pp. 279-311.

5. Dmowski, W.P. Hormonal and Surgical management of pelvic endometriosis. In: Principles of Microsurgery in Infertility, Edited by J.V.Reyniak and N.H. Lauerson. New York, Plenum Medical Book Company, 1982,   pp.233-272.

6. Dmowski, W.P. Danazol in the treatment of endometriosis and infertility. In: Recent Advances in Fertility Research, Vol. 112B, Developments in the Management of Reproductive Disorders, Edited by T.G. Muldoon, V.B. Mahesh, B. Perez-Ballester. New York, Alan R. Liss, Inc.. 1982, pp. 167-186.

7. Radwanska, E. and Dmowski, W.P. Ovulatory dysfunction and endometriosis. In: Recent Advances in Fertility Research, Vol. 112B, Developments in the Management of Reproductive Disorders, Edited by T.G. Muldoon, V.B. Mahesh, B. Perez-Ballester. New York, Alan R. Liss, Inc.. 1982, pp. 195-200.

8. Dmowski, W.P. Pharmacologic treatment of endometriosis. In: Gynecology and Obstetrics, Edited by H. Ludwig and K. Thomsen. Berlin-Heidelberg, Springer-Verlag, pp. 665-666, 1986.

9. Dmowski, W.P. Endometriosis: Association with infertility and office management. In: Office Gynecology, Third Edition, Edited by R.H. Glass. Baltimore, MD, Williams & Wilkins, 1987, pp. 317-336.

10. Dmowski, W.P. Alterations of the immune function and etiology of endometriosis. In: Recent Advances in Human Reproduction, Edited by Ricardo H. Asch. Fondazione Per Gli Studi Sulla Riproduzione Umana, 1987, pp 193-199.

11. Dmowski, W.P.. Radwanski, E., Binor, Z., and Tummon, I. GnRH agonists in the management of endometriosis. In: Human Reproduction, Current Status/Future Prospects, Edited by R. Iizuka and K. Semm. Elsevier Science Publishers B.V. (Biomedical Division), 1988, p. 497.

12. Dmowski, W.P., Rolland R., and Schweppe K.W. Endometriosis: Emphasis on new therapeutic modalities. Hoechst Meducation Update, Series Hormones. Hoechst Aktiengesellschaft, 1989.

13. Dmowski, W.P., Braun, D, Gebel, H. Endometriosis: Genetic and immunologic aspects, In: Current Concepts in Endometriosis, Proceedings of the Second International Symposium on Endometriosis, Houston, Texas, Edited by Dev R. Chadha and V.C. Buttram Jr.New York, Alan R. Liss, Inc., 1989, pp. 99-122.

14. Dmowski, W.P. Endometriosis as a factor in female infertility. In: Advances in Gynecology and Obstetrics, Proceedings of the XII th World Congress of Gynecology and Obstetrics, Rio de Janeiro, October 1988, Edited by P. Belfort, J.A. Pinotti and T.K.A.B. Eskes. Lancaster, Parthenon Publishing. 1989, pp. 121-124.

15. Dmowski, W.P. Radwanska, E., Binor, Z., Tummon, I., Pepping, P. GnRH agonists in the management of endometriosis: the results of two randomized trials. In: GnRH Analogues in Reproduction and Gynecology, Vol. 1, Edited by B.H. Vickery and B. Lunenfeld. Lancaster, Kluwer Academic Publishers, 1990, pp. 7-15.

16. Dmowski, W.P., Rotman, C. Endometriosis. In: Conn's Current Therapy, 1991, Edited by, Robert E. Rakel. Philadelphia, Saunders Co., 1991, pp. 989-992.

17. Dmowski, W.P., Braun, D., Gebel, H. The immune system in endometriosis. In: Modern Approaches to Endometriosis, Edited by John Rock. Kluwer Academic Publishers, 1991, pp. 97-111.

18. Dmowski. W.P. Endometriosis: In: Office Gynecology, Fourth Edition, Edited by Robert H. Glass. Williams and Wilkins, Baltimore, 1993,  pp. 359-380.

19. Dmowski, W.P., Braun, D.P., Gebel, H.M. Manipulation of the Immune System in Endometriosis. In: Proceedings of the Third World Congress on Endometriosis. Brussels, Belgium, June, 1992, Editors I. Brosens and J. Donnez New York, The Parthenon Publishing Group,  1993 pp. 257-268.

20. Dmowski, W.P. Effect of Endometriosis on In Vitro Fertilization/Embryo Transfer Success Rates. In: Perspectives on Assisted Reproduction. Edited by T. Mori, T. Aono, T. Tominaga, and M. Hiroi. Serono Symposia Series  "Frontiers in Endocrinology" Vol. 4. Ares-Serono Symposia Publications, Christengraf S.R.L. Rome Italy, 1994.

21. Dmowski, W.P. The Role of Medical Management in the Treatment of Endometriosis. In: Endometriosis: Advanced Management and Surgical Techniques. Edited by C. Nezhat and V. Buttram New York, Springer-Verlag,   1995, pp. 229-240.

22. Dmowski, W.P., Etiology and histogenesis of endometriosis: Current concepts and the mechanisms involved. In: Proceedings of ATTI LXXI Congresso Societa Italiana Di Ginecologia ed Ostetricia XXXVI Congresso Associazione Ostetrici Ginecologi Ospedalieri Italiani III Congresso Associazone Ginecologi Iniveristari Italiana (est.) OGOI, AGUI, Palermo. 1995, pp. 76-82.

23. Dmowski, W.P. Behandlung der minimal endometriose. In: Proceedings of the First German Congress on Endometriosis, Heidelberg, 1993, . Der Frauenarzt. Schweppe K.W., Schindler A.E.,  Semm, K. Runnebaum, B., (eds.), Demeter Verlag, Balingen, 1995, pp. 77-81.

24. Dmowski, W.P.. Braun, D.P., Rotman, C. Aspectos immunologicos de la endometriosis. In: Reproduccion Humana, Edited by J. Remohi, C. Simon, A. Pellicer, F. Bonilla-Musoles, Madrid, Spain, McGraw-Hill Interamericana  1996, pp. 195-203.

25. Dmowski, W.P. Effect of autoantibodies on embryo implantation. Proceedings of the Fifth World Congress on Endometriosis, Yokohama, Japan, 1997, Parthenon Publishing (in press).

26. Dmowski. W.P. Endometriosis. In: Esterilidad. (in press).

27. Dmowski, W.P., Braun, D.P. Immunologic Aspects of Endometriosis. In: Endometrium and Endometriosis. Walden, MA,   Blackwell Science.  pp. 174-181, 1997.