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It is a prevalent condition, impacting approximately 10% of women of reproductive age worldwideequating to around 190 million individualsand is highly associated with infertility, present in 3050% of women seeking infertility evaluation ( The pathophysiology involves complex interactions of endocrine, immunologic, and inflammatory processes, with retrograde menstruation as the most accepted theory for ectopic tissue implantation (6).Estrogen metabolism and chronic inflammation are key pathophysiological mechanisms, with emerging evidence highlighting the microbiomeparticularly the gut and genital tract microbiotain modulating estrogen metabolism and inflammation, potentially influencing disease etiology and symptomatology (7)

where they have enriched monocytes from healthy volunteers to generate the functional genomics datasets reanalyzed herein ( Cell Culture Monocytes were cultured in complete media consisting of Dulbeccos Modified Eagle Medium containing high glucose and sodium pyruvate (ThermoFisher Scientific) with 10% heat-inactivated fetal bovine serum (Wisent BioProducts) and 100U/mL penicillin/streptomycin (Corning)

10.1177/0706743716635535 257 LeeB.KwonJ.-T.JeongY.CarisH.OhD.FengM.et al