Endometriosis and infertility

Endometriosis is a common disease defi ned as the growth of endometrial tissue outside the cavity.Often results in a vast array of gynaecological problems: dyspareunia, dysmenhorea and pelvic pain.ln 1927, the theo r y that endometriosis is due to the implantation of the retrograde endometrium, seeded in the peritoneal cavity by means of retrograde menstruation was published.This retrograde menstruation occurs in 90% of women; however, only 1% -5% develops endometriosis.This suggests that other factor (s) determine the susceptibil ity of an individual to implantation and growth of this tissue, example, genetic susceptibility.A recent controlled prospec tive study, reported a prevalence of 38% in infertile women and 5% in others.When endometriosis causes structural dam age an effect on fe rtility is obvious.It is widely accepted that minimal to mild endometriosis is associated with subfertility.There is growing consensus that the endometriosis is not the cause of infertility or at least the cause is multifactorial, and many possibilities have been suggested: ranging from al tered folliculogenesis, ovulatory dysfunction, luteal phase defect, accelerated ovum transport, sperm phagocytosis im paired fertilization and defective implantation.