Abstract
Endometriosis consists of major five features including inflammation, angiogenesis, MMP activation, adhesion formation and anti-apoptosis which all exhibit adverse effects and severely interfere with embryo implantation. Meta-analysis also shows decreased mean number of eggs retrieved, compromised clinical pregnancy rates and live birth rates in women with endometriosis. Endometriosis impacts on human oocytes by decreased mitochondrial number, reduced mitochondria DNA copy number, and increased the abnormal mitochondrial ultrastructure. The embryo morphokinetics research by time-lapse observation in patients with ovarian endometriosis illustrates delay tM and tB around 2-3 hours compared with the controls. Medical treatment by GnRHa or Dienogest before ET or FET both can induce apoptosis and autophagy of endometriotic tissues and lead to diminished endometriosis related biomarkers Tensin1 etc.) and restores the implantation markers (HOXA 10). Translational clinical studies in IUI or IVF also demonstrated beneficial effects on pregnancy outcomes and decreasing miscarriage rate following GnRHa pretreatment.
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