Inagaki et al. evaluated the cytokine expression in uterine flushings from patients with adenomyosis, leiomyoma, and uterine polyps and found significantly higher TGF-β1 levels than in the control group.(13) In another study, using the same methodology, Liu et al.(3) observed a significant increase in platelet aggregation, TGF-β1 expression, and phosphorylated Smad3 in patients with endometriosis and adenomyosis compared with the control group.(3). This evidence concerns the gene SMAD3 and adenomyosis.