MORPHOLOGY AND PATHOGENESIS OF THE DETERIORATION OF THE OVARIAN RESERVE IN ENDOMETRIOSIS AND METHODS OF ITS PRESERVATION

The paper reviews the morphology and proposed pathogenesis of ovarian reserve deterioration in endometriosis, focusing on how endometriosis—especially when ovarian—can reduce primordial follicles and increase non-restorable growing follicles, with attention to mechanisms such as follicular “burnout,” disrupted steroidogenesis, inflammation/immune responses, and oxidative stress. It synthesizes evidence from sonographic and histologic findings, observations of impaired oocyte maturation and altered granulosa-cell function, and reports that higher reactive oxygen species and oxidative DNA damage markers in follicular/peritoneal environments are associated with meiotic and oocyte quality defects. The authors acknowledge that effectiveness and outcomes of fertility preservation technologies are critically debated, and that several mechanisms of endometriosis-associated infertility remain incompletely understood. This paper is centrally about endometriosis — it specifically addresses how endometriosis causes ovarian reserve deterioration and discusses methods proposed for preserving fertility.

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