Endometriosis, staging, infertility and assisted reproductive technology: time for a rethink.

Ata, Baris; Somigliana, Edgardo

Ata, Baris; Somigliana, Edgardo.

Afiliación

Ata B; Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkey.; ART Fertility Clinics, Dubai, United Arab Emirates.. Electronic address: barisata@ku.edu.tr.
Somigliana E; ART Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.

Reprod Biomed Online ; 49(1): 103943, 2024 Jul.

Article en En | MEDLINE | ID: mdl-38733678

ABSTRACT

ABSTRACT

How endometriosis causes infertility, with the exception of tubal dysfunction caused by adhesions, is unclear. The inflammatory milieu in the pelvis and impaired receptivity of the eutopic endometrium are considered to be possible factors. Anatomical staging systems fail to predict the fertility status of endometriosis patients. Data from assisted reproductive technology cycles consistently suggest that oocytes from patients with endometriosis have a normal potential to develop into euploid blastocysts. Moreover, oocyte or embryo recipients with endometriosis seem to have similar or slightly lower pregnancy and live birth rates compared with recipients without endometriosis, suggesting that eutopic endometrium is not or is only minimally affected, which may be caused by undiagnosed adenomyosis. In-vivo observations from women with endometriomas provide evidence against a detrimental effect of endometriomas on oocytes. Combined with the absence of an obvious improvement in fertility following the surgical destruction or excision of peritoneal endometriosis or from temporary medical suppression of the disease and the associated inflammation, the available evidence makes endometriosis-associated infertility questionable in the absence of tubal dysfunction caused by adhesions. It is likely that no anatomical staging will correlate with fertility beyond assessing tubal function. In patients with endometriosis assisted reproductive technology is as effective as for other indications.

Asunto(s)

Endometriosis; Infertilidad Femenina; Técnicas Reproductivas Asistidas; Humanos; Femenino; Endometriosis/patología; Endometriosis/complicaciones; Infertilidad Femenina/patología; Infertilidad Femenina/etiología; Embarazo

Palabras clave

Adhesions; Assisted reproductive technology; Endometrial receptivity; Endometriosis; Euploidy; Infertility

Texto completo

Añadir a Mi BVS

Imprimir

XML

PubMed Links

Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Técnicas Reproductivas Asistidas / Endometriosis / Infertilidad Femenina Límite: Female / Humans / Pregnancy Idioma: En Revista: Reprod Biomed Online Asunto de la revista: MEDICINA REPRODUTIVA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos

Texto completo

Añadir a Mi BVS

Imprimir

XML

PubMed Links

Buscar en Google