Endometriosis: impact on oocyte quantity and quality

Stéphanie Huberlant
In: Médecine de la Reproduction · 2024 · vol. 26(1) , pp. 71–73 · doi:10.1684/mte.2024.0987 · W4396679738
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-08-02 ⓘ

Endometriosis may negatively affect oocyte quantity and quality, impacting embryo development and requiring personalized assisted reproductive technology approaches due to controversial effects on pregnancy and live birth rates.

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This review examines the multifactorial causes of infertility associated with endometriosis, focusing on how the condition affects oocyte quantity and quality during assisted reproductive technology cycles. The authors highlight evidence of morphological abnormalities in oocytes and increased oxidative stress that may impair embryonic development, while noting that data regarding pregnancy and live birth rates remain controversial. Significant challenges include ovarian endometriomas limiting access during egg retrieval and the complex risk-benefit balance of surgical intervention for fertility preservation. This paper is centrally about endometriosis — specifically its impact on ovarian function and outcomes in assisted reproduction.

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Abstract

Endometriosis can be associated with infertility, the causes of which are multiple. Assistance reproductive technologies (ART) may be proposed, mainly involving in vitro fertilization. Many authors have studied the results of ART in patients with endometriosis. Morphological abnormalities in oocytes and an impact on embryonic development have been highlighted. The data are controversial as to the impact on pregnancy rates and live birth rates. There may also be an increase in oxidative stress, with known consequences for the oocyte and embryonic development. Particular attention has been paid to ovarian location. On the one hand, the presence of an endometrioma could limit ovarian access during oocyte retrieval, but the risk of infection is debated. On the other hand, the place of surgery is often discussed depending on the objectives (improving the patient’s quality of life and/or infertility) and the benefit-risk balance. Furthermore, even if endometriosis with ovarian lesions affects the number of oocytes collected, studies are still needed to establish the impact on pregnancy rates and birth rates. The complexity of endometriosis means that it has consequences for reproductive health and ART, requiring a personalized approach to patients.
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Médecine de la Reproduction MENUEndométriose : impact sur la quantité et la qualité ovocytaire Volume 26, numéro 1, janvier-février-mars 2024 - Mots-clés : endométriose, qualité ovocytaire, endométriome, taux de naissance vivante - DOI : 10.1684/mte.2024.0987 - Page(s) : 71-3 - Année de parution : 2024 L’endométriose peut être associée à une infertilité dont les causes sont multiples. Le recours à une aide médicale à la procréation (AMP) peut être proposé, principalement par fécondation in vitro. De nombreux auteurs se sont penchés sur les résultats en AMP des patientes atteintes d’endométriose. L’existence d’anomalies morphologiques des ovocytes a été mise en évidence ainsi que d’un impact sur le développement embryonnaire. Les données sont controversées quant à l’impact sur les taux de grossesses et de naissances vivantes. Il existerait également une augmentation du stress oxydatif, avec des conséquences connues sur l’ovocyte et le développement embryonnaire. Une attention particulière a été portée sur l’atteinte ovarienne. D’une part, la présence d’endométriomes pourrait limiter l’accès ovarien lors de la ponction ; le risque infectieux est débattu. D’autre part, la place de la chirurgie est souvent discutée, selon les objectifs (amélioration de la qualité de vie de la patiente et/ou infertilité) et la balance bénéfice-risque. Par ailleurs, même si l’endométriose avec atteinte ovarienne affecte le nombre d’ovocytes recueillis, des études sont encore nécessaires pour objectiver un impact sur les taux de grossesses et de naissances. Ainsi l’endométriose, de par sa grande complexité, présente des conséquences sur la santé reproductive et sur les résultats en AMP nécessitant une approche personnalisée des patientes atteintes.

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endometriosisendometriomainfertility

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