Endometrium or embryo quality in minimal or mild endometriosis - related infertility

Lela Iremadze, Arsen Gvenetadze, М. Гегечкори
In: Translational and Clinical Medicine - Georgian Medical Journal · 2017 · pp. 24–27 · doi:10.29088/tcm-gmj.2017.24 · W2772155934
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This review explores whether infertility in minimal or mild endometriosis stems from endometrial alterations or compromised embryo quality, noting conflicting evidence and the need for further research.

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This review examines the controversy surrounding whether minimal or mild endometriosis impairs fertility through altered eutopic endometrial receptivity or compromised embryo quality. The authors analyzed existing literature to determine if implantation defects in these patients originate from the uterine lining or the developing embryo, noting that moderate-to-severe disease is known to disrupt anatomical structures. While some studies report lower pregnancy rates and altered implantation markers in women with endometriosis compared to controls, the results remain contradictory and inconclusive. Consequently, the paper concludes that further rigorous research with adequate controls is necessary to identify the true pathophysiological origin of infertility in this population. This paper is centrally about endometriosis — specifically investigating the mechanisms by which minimal or mild disease affects fertility and implantation success.

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Abstract

Background : There is controversy related to pathogenesis and mechanism by which minimal or mild endometriosis affects fertility in women. It is accepted that moderate-severe endometriosis disrupt the anatomical relationships between fallopian tube and ovary. Some researchers found impaired implantation in patients with endometriosis, but such defects in implantation may be caused by either embryos or altered endometrium. Further investigations on follicular fluids have also found differences between women with endometriosis and women without the disease. In addition, recent advances on implantation research, show features in the eutopic endometrium of women with endometriosis that are not found in endometrium of women without the disease, although it is controversial. The review aims at describing the available information from the eutopic endometrium or embryo standpoint infertility related to endometriosis. Objective : To explore the interrelation of the eutopic endometrium or embryo in women with infertility and the endometriosis. Methods : Retrospective review of literature using all the available English databases, Cochrane register and articles which addressed the question “Whether the endometrium or embryo quality is different in women with endometriosis associated infertility?“ Conclusion : Although contradictory results have been reported, different clinical studies have demonstrated worse success rates for pregnancy in women with endometriosis compared with healthy women or with tubal factor among those that found lower pregnancy rates in women with endometriosis compared with controls without the disease, some found alterations in implantation rates in women with endometriosis when they were compared with controls. The debate continues, and other approaches should be developed before we can determine the authentic origin of the defects that make conception more difficult in these patients. These new studies must include an adequate design and controls, in order to avoid misleading data that can complicate the interpretation of the pathophysiology of this enigmatic disease.
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Abstract

Background: There is controversy related to pathogenesis and mechanism by which minimal or mild endometriosis affects fertility in women. It is accepted that moderate-severe endometriosis disrupt the anatomical relationships between fallopian tube and ovary. Some researchers found impaired implantation in patients with endometriosis, but such defects in implantation may be caused by either embryos or altered endometrium. Further investigations on follicular fluids have also found differences between women with endometriosis and women without the disease. In addition, recent advances on implantation research, show features in the eutopic endometrium of women with endometriosis that are not found in endometrium of women without the disease, although it is controversial. The review aims at describing the available information from the eutopic endometrium or embryo standpoint infertility related to endometriosis.

Objective

To explore the interrelation of the eutopic endometrium or embryo in women with infertility and the endometriosis.

Methods

Retrospective review of literature using all the available English databases, Cochrane register and articles which addressed the question “Whether the endometrium or embryo quality is different in women with endometriosis associated infertility?“

Conclusion

Although contradictory results have been reported, different clinical studies have demonstrated worse success rates for pregnancy in women with endometriosis compared with healthy women or with tubal factor among those that found lower pregnancy rates in women with endometriosis compared with controls without the disease, some found alterations in implantation rates in women with endometriosis when they were compared with controls. The debate continues, and other approaches should be developed before we can determine the authentic origin of the defects that make conception more difficult in these patients. These new studies must include an adequate design and controls, in order to avoid misleading data that can complicate the interpretation of the pathophysiology of this enigmatic disease. Full Text: PDFReferences References; Simpson JL, Elias S, Malinak LR, Buttram VC., Jr Heritable aspects of endometriosis. I. Genetic studies. American journal of obstetrics and gynecology. 1980;137(3):327–331. Epub 1980/06/01. [PubMed] Endometriosis and human infertility; the role of eutopic endometrium. Francesca Minici, Feerica Tiberi, Anna Tropea,Sebastiano Campo, Andrianoaanzone. Human Reprodaction Vol.23.no.3 pp.530-537 2008 American Society for Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. FertilSteril 1997;67:817-821. [PubMed] Reid GD. Endometriosis and infertility. e-Report 2005;1:1-5. [PubMed] Kennedy S.The patient’s essential guide to endometriosis. United Kingdom: Alden, 2003:pp42. PubMed] The Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility: a committee opinion. FertilSteril 2012;98(3):591–8. 4. [PubMed] Hughes EG, Fedorkow DM, Collins JA. A quantitative overview of controlled trials in endometriosis-associated infertility. FertilSteril 1993;59(5):963–70 Giudice LC, Kao LC. Endometriosis. Lancet 2004;364(9447):1789–99 [PubMed] N.Garrido,J.Navaro,J.Garcia-Velasco, A.Pellicer, C.Simon. Human Reproduction. Vol.No.1pp.95-103.2002 Ilesanmi AO, Castelbaum AJ, et al. Steroidogenetic Fector-1 activates the expression in an endometrial cell. alpha1 integrin. J Steroid BiochemMolBiol 1996;59(1):31–9. N.Garrido, J.Navarro, J. Garcia-Velasco, A.Pellicer, C.Simon. et al. Endometrial receptivity in the window of implantation. Human Reproduction 2002 ; 95-103 Endometriosis associated infertility – World Journal of Laparoscopic Surgery. January- April2008.9-15 Cahill.D.j.Wardle.P.G.Maile,L.A.Harlow and Hull (1995). Pituitary-ovarian dysfunction as a cause for endometriosis-associated and unexplained infertility [PubMed] Lessey BA, Yeh I, Castelbaum AJ, et al. Endometrial progesterone receptors and markers of uterine receptivity in the window of implantation. Ferti lSteril 1996; 65(3):477–83. Bridges, Noble, et.al. Creuset.al Hill and Rogers Biophysical Journal [PubMed] DOI: http://dx.doi.org/10.29088/TCM-GMJ.2017.24 Refbacks - There are currently no refbacks. ISSN: 2346-8491 (online)

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