Modern view on the etiology, pathogenesis and possibilities of diagnostics of external genital endometriosis

Endometriosis is a condition that determines the presence of functionally active glands and endometrial stroma outside the uterus, causing a chronic inflammation in these tissues. The prevalence of endometriosis varies between 5-10% for all women, 20-25% for gynecological patients and reaches 45-50% for women with infertility. The true frequency of endometriosis is not definitely known, and its growth over the past decades is associated with both the increasing frequency of the disease and the improvement of its diagnosis. Endometriosis occurs irrespective of ethnicity and race, socioeconomic conditions, at any age. Diagnosis of external genital endometriosis includes patients' complaints, clinical examination, ultrasound examination, sometimes magnetic resonance imaging. Much has been done to understand the mechanisms of endometriosis, but still the "gold standard" of diagnosis is invasive methods, especially laparoscopy. An early diagnosis will allow to timely develop treatment tactic aimed at treating endometriosis and preventing its further spread and recurrence. The search for possible biomarkers for the diagnosis of endometriosis continues. Among non-invasive methods, the most promising for future study and research is the microRNA and long non-coding RNA. Molecular genetic methods in achieving good sensitivity and specificity results will be able to improve the results of infertility treatment associated with endometriosis through earlier treatment including surgery. In addition, various research groups have high expectations regarding the role of microRNA and long non-coding RNA chains in evaluating the effectiveness of drug therapy. The purpose of this review was to collect and analyze data from the world's literature, search for new non-invasive markers for diagnosing this disease at the preclinical stages, as well as predicting the response to hormone therapy.