SFRP5 and adenomyosis: Cell proliferation and angiogenesis are critical factors that promote basalis endometrium invagination.[5] Previous studies have also suggested that the Hedgehog pathway induced proliferation of epithelial cells and stromal fibroblasts,[41, 42] as well as angiogenesis,[43] implying that IHH secreted by SFRP5+ epithelial ecotypes in the invaginating microenvironment may play an important role in adenomyosis pathogenesis via autocrine and paracrine mechanism.