Endometriosis afflicts an estimated 176 million women globally, yet it remains one of medicine's most diagnostically delayed and therapeutically underserved conditions — often taking a decade from symptom onset to confirmed diagnosis. The central problem has been the absence of laboratory models that faithfully replicate the disease's complexity at the cellular and molecular level. A shift toward patient-derived induced pluripotent stem cell (iPSC) platforms may fundamentally change that equation.
This comprehensive narrative review, synthesizing over 170 peer-reviewed publications spanning landmark genomic meta-analyses and cutting-edge 3D culture systems, maps the current state of endometriosis modeling. The authors evaluate how iPSC-derived organoids — reprogrammed from individual patients' cells — can capture the epigenetic signatures, hormonal responsiveness, and tissue-specific behavior of endometriotic lesions in ways that traditional cell lines and animal models cannot. The review also connects genome-wide association data identifying significant disease-risk loci to the potential for patient-stratified therapeutic screening within these platforms, bridging anatomical classification systems with molecular-level disease architecture.
Placing this work in broader context, iPSC-based disease modeling has already transformed research in cardiac and neurological conditions, enabling drug discovery and mechanistic interrogation that was previously impossible without human tissue. Endometriosis has lagged partly because of stigma, funding gaps, and the historical reliance on laparoscopic biopsy for any meaningful tissue sample. The iPSC approach sidesteps that barrier by allowing reprogramming from peripheral cells. Critically, this is a narrative review rather than a meta-analysis, meaning its conclusions reflect synthesis and expert interpretation rather than pooled statistical outcomes. The field also remains largely pre-clinical — robust validation of iPSC endometriosis models in drug-response prediction against real patient outcomes has not yet been demonstrated at scale. Still, the convergence of epigenomics, organoid biology, and personalized medicine represented here positions iPSC platforms as potentially paradigm-shifting infrastructure for a condition that has long lacked it.