Role of Endometriosis in Infertility and Embryonic Loss: More than Anatomical Reasons

Rudy Leon De Wilde

doi:10.19080/jgwh.2017.03.555612

Abstract

The association between endometriosis and infertility is widely recognized, but several studies demonstrate that endometriosis also affects pregnancy rates in different ways other than anatomical distortion of internal reproductive organs; however the evoking mechanisms are complex. In mild to advanced stages of disease, peritoneal adhesions, tubal obstruction, destruction of ovarian tissue or distortion of the uterine wall are evident originating factors of infertility or miscarriage.

Highlights

Clinic of Gynecology, Obstetrics and Gynecological Oncology, University Hospital for Gynecology, Pius-Hospital, Medical Campus University of Oldenburg, Germany
; Fax: Email: The association between endometriosis and infertility is widely recognized, but several studies demonstrate that endometriosis affects pregnancy rates in different ways other than anatomical distortion of internal reproductive organs; the evoking mechanisms are complex
The local immunologic alteration induced by endometriosis results in an inappropriate milieu for sperm, oocytes, embryo development and uterine receptivity [5]

Summary

Mini Review

Role of Endometriosis in Infertility and Embryonic Loss: More than Anatomical Reasons. ; Fax: Email: The association between endometriosis and infertility is widely recognized, but several studies demonstrate that endometriosis affects pregnancy rates in different ways other than anatomical distortion of internal reproductive organs; the evoking mechanisms are complex. The underlying abnormalities could explain the modest pregnancy rates achieved by currently available medical and surgical treatments, estimated in 52.9-83% in mild disease and 0-6,7% insevere disease [1]. Some of the known pathophysiologic factors implied in endometriosis-associated infertility are irreversible (Table 1). They generate functional and structural abnormalities of the hypothalamic-pituitary-ovary-endometrium axis, which in turn lead to retardation of sperm, oocyte and blastocyst transport, alteration of endometrial receptivity and, embryonic loss.

Abnormal uterine receptivity

Poor quality embryo development

Findings

Conclusion