Endometriosis, staging, infertility and assisted reproductive technology: time for a rethink
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OA: bronze
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⤵ 15 in-corpus citations
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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.
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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.
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References (11)
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- W2761047277 via openalex
- W4214754424 via openalex
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Cited by (16)
- Endometriosis: the current state of the problem 2026
- Endometriose und Kinderwunsch 2026
- Endometrioma Management : A Practice-Pattern Survey from the Geneva Consensus Session at the 2024 SEUD Annual Meeting 2026
- Predictive factors for spontaneous conception in women with moderate and severe endometriosis following operative laparoscopy: A cohort study 2025
- Endometriosis and infertility: pathophysiology, treatment strategies, and reproductive outcomes 2025
- Global, Regional and National Burden of Infertility due to Endometriosis: Results From the Global Burden of Disease Study 2021 and Forecast to 2044 2025
- Electroacupuncture Ameliorates Endometriosis-Associated Ovarian Dysfunction by Activating Nrf2 Pathway to Upregulate GPX4 Function and Inhibiting Ferroptosis 2025
- Mesothelin as a diagnostic biomarker in endometriosis: A cross-sectional study 2025
- Effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound in patients with adenomyosis 2025
- Association between endometriosis and endometrial polyps: a systematic review and meta-analysis 2025
- Machine learning prediction of clinical pregnancy in endometriosis patients following fresh IVF/ICSI-ET 2025
- Uterine anteroposterior diameter predicts spontaneous pregnancy outcomes in women under 35 years with adenomyosis: a retrospective study 2025
- Reproductive Outcomes in Infertile Women with Endometriosis Undergoing Assisted Reproductive Technology 2025
- Co-occurrence of endometriosis and uterine fibroids: a systematic review and meta-analysis 2025
- The Global, Regional, and National Burden of Infertility Due to Endometriosis in Women of Childbearing Age, 1990-2021: Results from the Global Burden of Disease Study 2021 and Forecast to 2044 2024
- [Establishment of a predictive nomogram for clinical pregnancy rate in patients with endometriosis undergoing fresh embryo transfer] 2024
Source provenance
- europepmc
- last seen: 2026-10-16T06:09:50.462052+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-16T06:07:37.459959+00:00
License: CC0
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