Endometriosis and Reproduction: What We Have Learned.

Jaime Garcia-Fernandez, Jaime García-Fernández, Juan A García-Velasco
The Yale journal of biology and medicine · 2020 · vol. 93(4) , pp. 571–577 · PMID:33005121 · PMC7513434 · W3090919070
article OA: gold CC0 ⤵ 11 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review details how ovarian damage, specifically quantitative impairment, is the primary fertility compromise in endometriosis, and discusses ovarian surgery and fertility preservation considerations.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This mini-review discusses what is known about how endometriosis affects fertility, emphasizing evidence from assisted reproductive technology, fertility markers, and the consequences of ovarian surgery. It highlights that the main damaging mechanism is a quantitative impairment of ovarian reserve (lower AFC and AMH, especially in advanced/bilateral ovarian disease), while endometrial receptivity is presented as not apparently affected, and it notes that surgery can reduce ovarian reserve and ovarian stimulation response without clearly improving pregnancy chances when done before ART, with explicit caveats that clinical variability and correlations (e.g., ASRM stage with fertility) are imperfect. It also describes multiple proposed fertility-limiting mechanisms beyond ovarian reserve and contrasts the less predictive ASRM staging with the more detailed Endometriosis Fertility Index (EFI). This paper is centrally about endometriosis — it reviews endometriosis-related mechanisms compromising reproduction and summarizes impacts on ovarian reserve, surgery, and ART outcomes.

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Abstract

Endometriosis, despite only affecting 10-15% of women of fertile age, is still an enigmatic disease. Recent developments in assisted reproductive technology have contributed to a better understanding of where and how endometriosis could compromise fertility. In this mini-review we will show how the main point of damage in endometriosis is quantitative impairment of the ovaries, if the "less is more" mantra should be applied when considering ovarian surgery, and when fertility preservation prior to ovarian surgery could be considered. Endometrial receptivity, however, does not seem to be affected.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Fertility Preservation Female Fertility Humans Reproduction 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.

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Cited by (11)

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