Research on Mechanism of Infertility in Endometriosis.

Objective:To investigate the mechanism of infertility of patients with pelvic mild endometriosis.Design:The changes of prostaglandins(PG)and macrophages(Mφ)in peritoneal fluid,and pregnancy rate and dysmenorrhea improvement of infertile patients with pevic mild endometriosis(EM)were observed after treatment by the Nd:YAG laser laparoscopy.Results:The number,size,phagocytic activity and acid phosphatase of Mφ and the concentrations of PG in peritoneal fluid of infertile patients with pelvic mild EM were signifcantly higher than those in the infertile controls.After teratment,prenancy rate was 75%,dysmenorrhea disappeared in 93% of patients,and the number,size,phagocytic activity and acid phophatase of Mφ and the concentrations of PG in peritoneal fluid were significantly decreased.However,the concentration of PG in peritoneal fluid before laser treatment were higher in pregnant patients than those in nonpregnant patients.Conclusion:The pelvic endometriotic lesions may produce a great deal of PG increasing the concentrations of PG in peritoneal fluid,and stimulate Mφ entering peritoneal cavity and be activated subsequently resulting in infertility and dysmenorrhea.The Nd:YAG aser laparoscopy treatment could decrease the number and activity of Mφ as well as the concentrations of PG in peritoneal fluid,thereby increasing the chance of pregnancy and improving dysmenorrhea,but the pregnancy rate would be influenced by other coexisting infertile factors and the period of infertility.