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

Baris Ata, Barış Ata, Edgardo Somigliana
Reproductive biomedicine online · 2024 · vol. 49(1) , pp. 103943 · doi:10.1016/j.rbmo.2024.103943 · PMID:38733678 · W4392713730
review OA: bronze CC0 ⤵ 15 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This paper questions current endometriosis staging, its impact on infertility, and the optimal use of assisted reproductive technologies, advocating for a reevaluation of established practices.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

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.

My notes (saved in your browser only)

Condition tags

endometriosisinfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Reproductive Techniques, Assisted Reproductive Techniques, Assisted Reproductive Techniques, Assisted Reproductive Techniques, Assisted

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (11)

Cited by (15)

Source provenance

europepmc
last seen: 2026-06-14T06:08:20.186862+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-06-14T06:06:16.139149+00:00
License: CC0 · commercial use OK