Adhesions and endometriosis: challenges in subfertility management

De Wilde RL, Rudy Leon De Wilde, R L De Wilde, Alvarez J, Jesus Alvarez, J Alvarez, H Brölmann, Hans A.M. Brölmann, Brölmann H, R Campo, Campo R, Y Cheong, Ying Cheong, Lundorff P, Per Lundorff, P Lundorff, Leszek Pawełczyk, L Pawelczyk, H Roman, Roman H, Horace Roman, Attilio Di Spiezio Sardo, A di Spiezio Sardo, di Spiezio Sardo A, M Wallwiener, Markus Wallwiener
Archives of gynecology and obstetrics · 2016 · vol. 294(2) , pp. 299–301 · doi:10.1007/s00404-016-4049-2 · PMID:26894304 · PMC4937065 · W2408697142
article OA: gold CC0 ⤵ 9 in-corpus citations
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⚙ AI-generated summary by claude@2026-07, 2026-07-09 ⓘ

Endometriosis negatively impacts ovarian function and pregnancy outcomes, potentially through anatomical distortion, inflammation, oxidative damage, and oocyte quality reduction.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

The paper describes the ANGEL Group, an expert panel of European gynecological surgeons from nine nations, and their efforts over the last five years to generate awareness and evidence for the clinical benefits of adhesion prophylaxis, with an ongoing focus on adhesion prophylaxis in endometriosis-related surgeries. It outlines the group’s purpose as identifying opportunities to reduce adhesions by collective proposals for actions to prevent them, under the auspices of the ESGE Adhesions Research Special Interest Group. The article states that it contains no human or animal studies performed by its authors, and it does not report original experimental results. This paper is centrally about endometriosis — it specifically highlights adhesion prophylaxis challenges and future work in endometriosis-related surgeries.

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Abstract

There is molecular evidence that endometriosis has a negative impact on the ovaries, although the exact pathophysiology concerning endometriosis-associated subfertility is not known. The negative impact on the tubo-ovarian unit can be directly by distorting the anatomy, indirectly by invoking inflammation or by oxidative damage with poorer-quality oocytes. Endometriosis even seems to have a negative effect on pregnancy outcome after in vitro fertilization.
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Ack

The ANGEL Group, consisting of experts out of nine different nations, has invested significant efforts and resources in improving general awareness and generating evidence on the clinical benefits of adhesion prophylaxis during the last 5 years; this work will be continued with a special impact on adhesion prophylaxis in endometriosis-related surgeries. The ANGEL Group is a panel of European gynaecological surgeons focused on identifying opportunities to reduce the incidence of adhesions through collective expert proposals on actions to take to prevent adhesions. The members of the ANGEL Group are: Dr. Julio Alvarez (Spain), Prof. Hans Brölmann (Netherlands), Dr. Rudi Campo (Belgien), Dr. Ying Cheong (United Kingdom), Prof. Philippe Koninckx (Belgium), Prof. Per Lundorff (Denmark), Prof. Leszek Pawelczyk (Poland), Prof. Horace Roman (France), Dr. Attilio di Spiezio Sardo (Italy), Dr. Markus Wallwiener (Germany), Prof. Rudy Leon De Wilde (Germany).

Fn Group

Under the auspices of the ESGE Adhesions Research Special Interest Group (European Society of Gynecological Endoscopy). The members of the ANGEL Group are given in Acknowledgments.

Compliance

This study was funded by NORDIC Pharma Europe. All authors received reimbursement of travel expenses and accommodation costs by NORDIC Pharma Europe. This article does not contain any studies with human participants or animals, performed by any of the authors.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Infertility, Female Tissue Adhesions Tissue Adhesions Endometriosis Endometriosis Female Fertilization in Vitro Gynecologic Surgical Procedures Gynecologic Surgical Procedures Gynecology Humans Oocytes Ovary Postoperative Complications Pregnancy Pregnancy Outcome

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