CERT Research

Conducting endometriosis-related research is an important part of the mission of UC San Diego Health System’s Center for Endometriosis Research and Treatment (CERT).

Often undiagnosed, chronic pelvic pain affects one in seven women. Endometriosis is a significant public health problem as it has a huge impact on quality of life for women and their families. It impacts women's emotional well-being, social functioning, energy and employment. It should therefore be a priority clinical and research topic.

Our Goals

The goal of our research is to:

  1. Better understand endometriosis and how it affects women.
  2. Develop and evaluate promising new therapies for endometriosis.

Research Projects

UC San Diego is currently involved with two research projects related to the diagnosis and treatment of endometriosis.

1. Characterization of a Novel Clinical Marker of Endometriosis

Surgery is currently the standard for diagnosing endometriosis. Lack of a less invasive clinical test results in delayed diagnosis (for some women up to 12 years or more). Additionally, the health care costs associated with endometriosis are similar to or greater than other chronic diseases such as Crohn’s disease and diabetes. This is why there is an urgent need to find other safer and less costly diagnostic methods.

Initial findings suggest that the levels of a protein in the blood involved in nerve growth are much higher in women with endometriosis compared to healthy women.

Furthermore, our results show that protein levels are unaffected by the stage of the menstrual cycle and could be related to patient reports of pelvic pain.

Therefore, we suggest that these proteins are potentially important tools in diagnosing endometriosis. We are conducting a pre-clinical discovery phase project to better characterize the levels of this blood protein.

2. Comparison of Contraceptive Options

This study will compare contraceptive options (continuous oral contraceptives and levonorgestrel-releasing intrauterine device) in women with presumed endometriosis-related pelvic pain.

If you have painful periods or pelvic pain at other times and would like to hear more about taking part in this study, one of our researchers would be happy to discuss this study with you.

For more information on this study, call 619-940-4377.


Select published endometriosis-related studies by members of CERT (since 2008):

  • Foster WG, Boutross-Tadross O, Elias R, Faghih N, Elit L. (2009) Immunolocalization of tyrosine kinase receptors Trk A and Trk B in endometriosis associated ovarian cancer (EAOC). Histopathol. 54(7)907-912.
  • Foster WG, Neal MS, Han MS, Dominguez MM. (2008) Environmental contaminants and human infertility: Hypothesis or cause for concern? J. Toxicol. Environ. Hlth. Part B, 11:162–176.
  • Foster WG. (2008) Endocrine toxicants including TCDD and dioxin-like chemicals and endometriosis: Is there a link? J. Toxicol. Environ. Hlth. Part B, 11:177–187.
  • Anger DL, Foster WG. (2008) The link between environmental toxicant exposure and endometriosis re-examined. Frontiers in Bioscience 13:1578-1593. (Invited review)
  • Holloway AC, Anger DA, Crankshaw DJ, Foster WG. (2008) Effect of atrazine on aromatase activity in estrogen sensitive target tissues. J. Appl. Toxicol. 28:260-270.


Current endometriosis-related grant by CERT members:

  • Foster WG. Neurotrophins and Trks: Novel reproductive tract proteins. Natural Sciences and Engineering Research Council (NSERC) 2008 – 2013.

The Cost of Endometriosis

In 1994, the Gallup Organization called U.S. households to identify women between the ages 18 and 50 who experienced pelvic pain for more than six months.

Of the 5,263 women who participated, 14.7 percent reported chronic pelvic pain. Women with chronic pelvic pain were surveyed for severity, frequency, diagnosis, quality of life, time lost from work, lost productivity and health care utilization. Of the 301 women who received a diagnosis from a physician, 25 percent had endometriosis.

Women diagnosed with endometriosis reported:

  • More pain during and after intercourse
  • Disruption of work and other daily activities
  • Lower general health scores.

It is estimated that direct medical costs for outpatient visits for chronic pain for the U.S. population of women aged 18 to 50 years is approximately $881.5 million per year, and total direct costs (physician costs plus out-of-pocket expenses) to be $2.8 billion dollars annually.

Furthermore, time off from work was reported in 15 percent of women diagnosed with pelvic pain, and 45 percent indicated reduced productivity on account of the pain.

Make An Appointment

Call 858-657-8745

Our Research Director

Warren Foster, PhD, is a professor in the Department of Obstetrics & Gynecology at McMaster University and the director of the important research component of CERT. Dr. Foster's research aims to expand understanding of mechanisms underlying infertility, as well as the affect of certain lifestyle factors on endometrium.