Murat Osman

Senior Research Columnist: Murat Osman is a MD candidate at The George Washington University School of Medicine and Health Sciences. His interest in research is primarily focused on Medical Oncology and Radiology. He is also focused on cultivating his passion for medical science and human health through scientific writing and advocacy.

The duration of impairment of ovarian reserve after laparoscopic surgery

Endometriosis is a chronic medical condition characterized by ectopic endometrial tissue that grows and invades extra-uterine tissues. It is a significant contributor to chronic pelvic pain in women of reproductive age. Endometriosis involving the ovaries and causing a cystic growth is called an "endometrioma". Laparoscopic ovarian cystectomy (LOC) for endometriomas has been widely used but may be associated with decreased ovarian reserve. Several hormonal markers including anti-mullerian hormone (AMH) have been used to assess ovarian reserve. In the present study,…

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Priorities and Unmet Needs of Endometriosis Management

Endometriosis is a systemic, chronic disease that is a significant contributor to morbidity in young women. Although endometriosis has gained increasing attention in the medical field, scientific progress for an effective and definitive treatment modality is progressing slowly. The Society for Women’s Health Research (SWHR), a non-profit organization, aimed to aid the current understanding of this disease, has designed a roundtable meeting to review both the diagnostics and treatment of endometriosis. An interdisciplinary dialogue between researchers, clinicians, patients, industry, and…

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Signs and Symptoms on Transvaginal Ultrasound associated with the presence of endometriosis.

Endometriosis is a disease whereby ectopic endometrial cells are present outside of the uterus. Transvaginal ultrasound (TVUS) is a highly specific test for endometriomas and deep endometriosis to assess the involvement of endometriosis in the posterior anatomic compartments. While the diagnosis of these involved areas can be performed using ultrasonography, the gold standard continues to be surgery and histopathologic confirmation especially for the diagnosis of superficial endometriosis. This study conducted by Reid et al. from several institutions in Sydney, Australia…

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Development of Less Invasive Diagnostic Tests for Endometriosis Through Proteomics

Proteomics is a field which utilizes various methods to carry out large-scale studies of proteins. Due to the inherent nature of the field, proteomics focuses on the identification, localization, and functional analysis of the protein make-up of a given type of cell. Understanding different proteins and their function, expression, and structure allow researchers to understand complex disease processes and identify new drug targets that may be useful in the clinical setting for individuals who suffer from endometriosis. Currently, the gold…

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Lipophilic Statins inhibit growth and invasiveness of human endometrial cells

Endometriosis is a disease process whereby cells of the endometrium grow and invade structures outside of the uterus. Through recent research, it has been seen that endometriotic foci in women with endometriosis exhibit an altered phenotype that contributes to its invasiveness and abnormal proliferation. Thus, understanding the interaction of potential medications to slow or halt the progression of endometriosis would allow for more targeted therapies to be developed. Statins are a class of HMG-CoA reductase inhibitors widely used today as…

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Laparoscopic mesenteric vascular and nerve sparing surgery as a tool for DIE resection

Endometriosis can be characterized by a wide range of clinical aggressiveness based upon the location, character, and growth of ectopic endometrial implants. As one of the most aggressive forms of endometriosis, deep infiltrating endometriosis (DIE) is known to involve the colon and bladder. Surgery in these patients may lead to complications such as urinary retention, constipation and sexual dysfunction. Surgical techniques aimed at minimizing these complications are being developed such as pelvic nerve-sparing surgery.  The researchers from the Department of…

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Feasibility of MRI-Transvaginal Ultrasound Imaging for Deeply Infiltrating Endometriosis

Endometriosis is a disease whereby endometrial tissue is present outside of endometrium. A specific form of endometriosis, Deeply Infiltrating Endometriosis (DIE), is characterized by endometriotic glands that invade through the endometrium and other structures in the pelvis and is associated with significant morbidity. Developing noninvasive and safe imaging techniques that accurately diagnose DIE will allow for a patient’s team of doctors to plan for appropriate treatments. Fusion imaging is a new technology and includes the merging of cross-sectional imaging data…

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How Ovarian Endometriomas and DIE affect ART outcomes

Previous studies have evaluated the impact of an ovarian endometrioma on ovarian reserve and its impact on the success of assisted reproductive technology (ART) outcomes have controversial results.  ART is a method by which a woman’s own hormones are used in a controlled and timed clinical setting to achieve fertility. One such hormone, anti-Müllerian hormone (AMH) is routinely used to predict how well a woman is likely to respond to ovarian stimulation for in vitro fertilization (IVF) treatment and what doses of…

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Endometriosis involvement of the pouch of Douglas: TVUS vs pelvic exam

Deep infiltrating endometriosis (DIE) can lead to a partial or complete obliteration of the pouch of Douglas (POD). POD involvement has been associated with dyschezia, deep dyspareunia, and increased infertility rates. Assessing the extent of endometriosis involvement of the cul-de-sac allows surgeons to plan an appropriate surgical course to maximize morbidity. The presence of POD involvement can be assessed through TVUS via a technique known as the “sliding sign” or through a routine pelvic examination. The sliding sign technique assesses whether…

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Toxic Pelvic Cavity and Infertility

Endometriosis is a disease defined by the presence of endometrial tissue outside of the uterine cavity and has an incidence of approximately 10% in women of reproductive age. Thus, it is an important consideration in chronic pelvic pain and infertility in this age group. Additionally, it can also interfere with the success of assisted reproductive technology (ART) and in vivo conception. Removing endometriotic lesions via surgery has been seen to improve the ability to conceive naturally between 12-18 months after…

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A Balancing Act: How Endometriosis Invades the Body

Endometriosis is a disease defined by the presence of endometrial tissue outside of the uterine cavity. Ectopic endometrial tissues have been shown to have some features that mimic malignancy. For example, endometriosis can invade surrounding structures and attach to surfaces such as the ovary and peritoneum. This ability is thought to be linked to matrix metalloproteinases (MMPs), a group of enzymes that are involved in extracellular matrix and basement membrane breakdown and remodeling. Several different MMPs have been classified depending on…

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Coumarin based compounds found to inhibit the estradiol synthesis pathway

Endometriosis is a disease characterized by ectopic endometrial tissue outside the endometrium. Several biochemical and molecular pathways have been researched and used to alleviate endometriosis symptoms by inhibiting key molecules involved in the menstrual cycle. This review paper by Niinivehmas et al. titled, “Blocking oestradiol synthesis pathways with potent and selective coumarin derivatives”, published in the Journal of Enzyme Inhibition and Medicinal Chemistry, aims to present the different coumarin derivatives that have been investigated to inhibit an enzyme involved in…

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Oxidative Stress and Endometriosis

Endometriosis is a disease characterized by ectopic endometrial tissue outside the endometrium and is associated with a background of a chronic inflammation. Recent studies have aimed to elucidate the inflammatory mediators involved in endometriotic lesions by studying immune cell interactions, reactive oxygen species (ROS), and free radicals within the related areas. This review paper by Vitale et al. titled, “The Role of Oxidative Stress and Membrane Transport Systems during Endometriosis: A Fresh Look at a Busy Corner” and published in…

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Health-related quality of life in women with Endometriosis and Rheumatoid Arthritis

Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Unfortunately, endometriosis continues to be a leading cause of chronic pelvic pain and long-term morbidity in women of reproductive age. A large contributor to endometriosis-related morbidity are the physical symptoms associated with the disease: dysmenorrhea, dyspareunia, and infertility. This article titled, “Health-related quality of life in women with endometriosis, compared to the general population and women with rheumatoid arthritis” by…

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East/South East Asian Ethnicity and Moderate-to-Severe Endometriosis

Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Understanding how this disease affects diverse groups of people will aid doctors in assessing and diagnosing populations that are high-risk for advanced endometriosis. This article titled, “East/South East Asian Ethnicity and Moderate-to-Severe endometriosis” published in The Journal of Minimally Invasive Gynecology by Williams et al. from institutions in British Columbia and Alberta, Canada aims to investigate the ethnic differences for…

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Is there a definitive guideline for the surgical management of endometriosis?

Endometriosis is a chronic inflammatory disease that is defined by the presence of ectopic endometrial tissue outside of the uterus. Unfortunately, endometriosis continues to be a leading cause of chronic pelvic pain in women of reproductive age. This article titled, “Surgical treatment of different types of endometriosis…” by Kho et al. from the Women’s Health Institute in Cleveland clinic and institutions in Sao Paulo, Brazil aim to elucidate and compare the current treatment options and guidelines for patients with different…

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What is being done to help surgeons detect endometriosis during laparoscopy

The gold standard for the diagnosis of endometriosis is diagnostic laparoscopy and histologic confirmation. During laparoscopy, visualization of as many lesions as possible may hold better long-term clinical outcomes. Peritoneal endometriosis is difficult to diagnose intraoperatively due to the heterogeneity of the endometriotic lesions (lesions are currently grouped as either non-pigmented, red, white, or black based on gross findings). Thus, enhanced imaging techniques such as contrast agents may have the potential to aid surgeons in locating these lesions and providing…

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Contraceptives for the management of endometriosis pain

Endometriosis is a common gynecologic disease that affects many women of reproductive age and is associated with significant morbidity. One of the treatment options for women with endometriosis is the use of oral contraceptives (OCPs) for pain management. However, its effectiveness has not been clearly presented in randomized control studies.  This article titled, "Oral contraceptives for pain associated with endometriosis" by Brown et al. published in the "Cochrane Database of Systematic Reviews" aims to determine if there is any significant…

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Therapeutic strategies involving uterine stem cells in reproductive medicine

Stem cells are undifferentiated cells that often serve to regenerate tissue in states of injury or apoptosis. The endometrium has progenitor cells that replace tissue lost after each menstrual cycle. It has been postulated that excessive stem cell recruitment to the endometrium may contribute to the development of endometriosis. Thus, preventing stem-cell trafficking may lessen disease progression. Bone marrow-derived stem cells are mesenchymal stem cells that originate from the bone marrow. These cells not only produce immune cells, but also…

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Emerging medical treatments for endometriosis

Endometriosis is a disease whereby uterine tissue grows outside the walls of the uterus to the surfaces of other tissues in the body. It is a chronic disease and relies upon estrogen to grow and survive. Current medical therapies take advantage of this weakness by creating a hypoestrogenic environment either by blocking ovarian estrogen secretion (GnRH-agonist, GnRH-a) or by inhibiting estrogenic stimulation of the ectopic endometrium (progestins and androgenic progestins). Clemenza and authors at the University of Florence, Italy have…

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