{"paper_id":"5bba0a2f-a10e-4124-85d4-8ee436d6f924","body_text":"Endometriosis and Infertility: Mechanisms, Clinical Impact, and Diagnostic Advances\n##plugins.themes.bootstrap3.article.main##\nAbstract\nEndometriosis is a chronic, estrogen-dependent inflammatory disease characterized by the presence of endometrial-like tissue outside the uterus. It affects an estimated 10% of women and girls of reproductive age worldwide, or approximately 190 million people, and diagnosis is delayed by six to ten years on average because symptom presentation is heterogeneous and no non-invasive test is definitive. This entry examines infertility, which affects roughly 30% of individuals with endometriosis, as a central consequence of the disease. It advances a single organizing argument: dysregulation of the pelvic and endometrial immune environment links the pathophysiology of endometriosis to its clinical impact on fertility and to emerging diagnostic and prognostic tools. Aberrant macrophage and natural killer (NK) cell function permits ectopic lesions to persist while generating an inflammatory milieu that impairs sperm, oocyte, and embryo quality and disrupts implantation. These mechanisms, together with anatomic distortion and endometrioma-related loss of ovarian reserve, explain the clinical burden of endometriosis-associated infertility. Advances in pelvic imaging, ovarian reserve testing, and the Endometriosis Fertility Index now allow clinicians to individualize fertility care, while biomarkers derived from the underlying immune alterations remain an active area of investigation.\n##plugins.themes.bootstrap3.article.details##\nThis work is licensed under a Creative Commons Attribution 4.0 International License.","source_license":"CC0","license_restricted":false}