ENDOMETRIOSIS ASSOCIATED INFERTILITY: VERSIONS AND COUNTERVERSIONS

I.M. Ordiyants, Z.V. Zyukina, Dmitriy Sergeevich Novginov, Birlant Abubakarovna Dzhabrailova, D. R. Asatryan
In: Ulyanovsk Medico-biological Journal · 2023 · pp. 6–13 · doi:10.34014/2227-1848-2023-3-6-13 · W4387102454
article OA: bronze CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review discusses molecular and genetic characteristics of the endometrium, endometrium receptivity models, and female infertility pathogenesis associated with endometriosis, highlighting signaling pathways and the need for better diagnostic criteria.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This 2023 narrative review examines current ideas on endometrial receptivity in endometriosis-associated infertility, drawing on literature about molecular-genetic, epigenetic, immune, and steroid-hormone–related mechanisms in women with outer genital endometriosis. It reports that during the implantation window in endometriosis-associated infertility, key implantation molecules such as LIF, HOXA-10, glycodelin A, and certain integrins show reduced expression, while markers of receptivity including VEGF increase and are linked to altered microRNAs (e.g., miR-29c, miR-33b, miR-199a-5p, miR-210) and downstream dysregulation involving miR-145 and miR-451. A major caveat emphasized is the lack of consensus and the heterogeneity/limitations across studies and diagnostic approaches, with the review noting that structural–metabolic consensus on endometrial changes has not been reached and that receptivity lacks clear defining structural-metabolic characteristics. This paper is centrally about endometriosis — it specifically reviews endometrial receptivity mechanisms implicated in endometriosis-associated infertility in the context of outer genital endometriosis.

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Abstract

Reproductive disorders rank as rather challenging problems in modern gynecology. At present, there is no unequivocal opinion and unified approaches to endometrial receptivity. The change in this complex process causes implantation disorders. The article provides up-to-date information on the molecular and genetic characteristics of the endometrium and on endometrium receptivity models. It also touches upon the pathogenesis of female infertility, associated with external genital endometriosis (EGE). Numerous foreign and domestic articles consider gene expression in endometriosis. According to the published data, the number of differentially expressed genes in endometriosis varies significantly. It has been proven that if mutations occur in a single gene, its function can still be performed due to compensatory mechanisms. Such compensation is provided by the work of signaling pathways – cascades of protein-protein interactions that transmit signals inside the cell. It is known that the degree of activation of intracellular signaling pathways is a better marker of a pathological process than gene expression. Comparison of eutopic and ectopic endometrium is one of the promising lines of endometriosis research. It is revealed that the abovementioned endometrial samples are similar in morphological characteristics, but this fact has not led to the creation of a single diagnostic test. Thus, it is relevant to search for new statistically valid criteria for early diagnosis of endometriosis using minimally invasive or non-invasive research methods that would also allow predicting the disease recurrence and improve the quality of predicting endometriosis associated infertility.

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endometriosisinfertility

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