CLINICAL RELEVANCE OF THE BABOON AS A MODEL FOR THE STUDY OF ENDOMETRIOSIS

Objective: To review the value of the baboon as a model for the study of endometriosis. Data Identification and Selection: Studies performed at the Institute of Primate Research in Nairobi, Kenya (1990-1994), a nd published in peer-reviewed journals. Result(s): Spontaneous endomet riosis was found in about 25% of the baboons, and its prevalence incre ased with the duration of captivity. The laparoscopic appearance, pelv ic localization, and microscopic aspects of the disease were similar t o endometriosis in women. Microscopic endometriosis in macroscopically normal peritoneum was rare. Sampson's hypothesis (i.e., retrograde me nstruation causes endometriosis) was supported by the increased incide nce of retrograde menstruation in baboons with spontaneous endometrios is, the obsecration that cervical occlusion could cause retrograde men struation and endometriosis, and the finding that intrapelvic injectio n of menstrual endometrium caused experimental moderate to severe endo metriosis similar to the spontaneous disease. During follow-up of more than 2 years, endometriosis in baboons appeared to be a progressive d isease, with active remodeling between several types of lesions. Progr ession was stimulated by high-dose immunosuppression. Fertility was no rmal in baboons with minimal disease but was reduced in baboons with m ild, moderate, or severe endometriosis, possibly related to an increas ed incidence and recurrence of the luteinized unruptured follicle synd rome. Conclusion(s): The baboon is a good model for the study of endom etriosis. (C) 1997 by American Society for Reproductive Medicine.