Endometrium or embryo quality in minimal or mild endometriosis - related infertility

Abstract

Background:    There is controversy related to pathogenesis and mechanism by which minimal or mild endometriosis affects fertility in women. It is accepted that moderate-severe endometriosis disrupt the anatomical relationships between fallopian tube and ovary.  Some researchers found impaired implantation in patients with endometriosis, but such defects in implantation may be caused by either embryos or altered endometrium.  Further investigations on follicular fluids have also found differences between women with endometriosis and women without the disease. In addition, recent advances on implantation research, show features in the eutopic endometrium of women with endometriosis that are not found in endometrium of women without the disease, although it is  controversial. The review aims at describing the available information from the eutopic endometrium  or embryo standpoint  infertility  related to endometriosis.

Objective: To explore the interrelation of the eutopic endometrium or embryo in women with infertility and the endometriosis.

Methods:  Retrospective review of  literature  using all the available English databases, Cochrane  register  and articles which addressed  the question “Whether the endometrium  or embryo quality  is different  in women with endometriosis  associated  infertility?“

Conclusion:  Although contradictory results have been reported, different clinical studies have demonstrated worse success rates for pregnancy in women with endometriosis compared with healthy women or with tubal factor among those that found lower pregnancy rates in women with endometriosis compared with controls without the disease, some found alterations in implantation rates in women with endometriosis when they were compared with controls. The debate continues, and other approaches should be developed before we can determine the authentic origin of the defects that make conception more difficult in these patients. These new studies must include an adequate design and controls, in order to avoid misleading data that can complicate the interpretation of the pathophysiology of this enigmatic disease.