Background: Low birth weight (LBW) is a risk factor associated with endometriosis. Our study aimed to analyze the risk of endometriosis in women with a LBW history and the relationships of progesterone receptor B (PR-B) gene promoter methylation, DNA methyltransferase-1 (DNMT1) expression, PR-B expression, and vascular endothelial growth factors (VEGF) with endometriosis. Methods: This study was conducted in two stages, a retrospective case-control design and a cross-sectional design, with 52 cases of endometriosis and 30 controls, which were further subdivided into LBW and non-LBW groups, at Hasan Sadikin General Hospital and its hospital networks from October 2017 to August 2021. Menstrual blood was taken from subjects and analyzed using pyrosequencing techniques to assess DNA methylation, while q-RT PCR was used to assess gene expression. Results: There were significant differences in PR-B methylation, DNMT1 expression, PR-B expression, and VEGF expression (p < 0.001) between the case and control groups. There was a significant negative correlation between PR-B methylation and PR-B expression (r = −0.558; p = 0.047). Based on a multiple logistic analysis, the most dominant factor affecting endometriosis incidence is PR-B (OR 10.40, 95% CI 3.24–33.4, R² = 45.8). We found that patients with a low birth weight history had a 1.41-times-higher risk of developing endometriosis (95% CI 0.57–3.49, p = 0.113), although the relationship was not statistically significant. Conclusion: Endometriosis is associated with PR-B gene promoter hypermethylation, decreased PR-B expression, and increased DNMT1 and VEGF expression. The methylation of PR-B is the most dominant factor affecting endometriosis incidence.

Adenomyosis is a pathological condition characterized by the presence of endometrial glands and stroma within the myometrium. Endometrial like cells development was influenced by local inflammatory reactions, increases local estradiol due to asynchromatized estrogen synthesis (ER beta) and then stimulated to proliferation and fibrosis, are also irritation on small nerve fibers in women with painful characterized symptoms on adenomyosis. There are expressions of neurofilament protein (NF) and protein gene product 9.5 (PGP 9.5) is a highly specific panneuronal marker for microfilament nerve fibers and is related to presenting pain with adenomyosis symptoms. A retrospective immunohistochemical study of thirty samples histopathological of adenomyosis as study groups and 30 with control groups between 25-49 ages which were established at Dr. Hasan Sadikin General Hospital and the satellites in April 2014-May 2015. This case-control analyzed ER beta, NF, and PGP 9.5 expressions compared and correlation between study groups and controls. The results showed there were significant differences in expression of ER beta, NF, and PGP 9.5 on adenomyosis higher than the control study (p<0.05). The intensity was higher and very strong into the study groups (p6(sensitivity 66.7%; specificity 70%), NF>3 (sensitivity 93%; specificity 46%), PGP 9.5>4 (sensitivity 90%; specificity 67%). Odds Ratio (CI 95%) ER beta>6=4.67; NF >3=12.25; PGP 9.5 >4=24.75 (p<0.001). The value of histoscore of ER beta and PGP9.5 have correlates to adenomyosis, the differences were statistically significant (p<0.05). The conclusion were that the adenomyosis had higher ER beta, NF, and PGP 9.5 expressions. There are simultant correlates and positive values between ER beta, NF, and PGP9.5 based on etiophatogenesis of pain on adenomyosis.