Factors Causing Infertility in Women Diagnosed with Endometriosis

In: International Journal of Medical Science and Clinical Research Studies · 2022 · vol. 02(10) · doi:10.47191/ijmscrs/v2-i10-16 · W4307164549
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Endometriosis-associated infertility in women is multifactorial, involving oxidative stress, dysregulated steroidogenesis, altered cytokine production, and pelvic, ovarian, and genetic factors.

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The paper reviews factors and proposed mechanisms associated with infertility in women diagnosed with endometriosis, describing endometriosis as ectopic endometrial glands and stroma in sites such as the ovaries and pelvic ligaments. It highlights multiple pathways, including oxidative stress–related effects on oocyte recovery and maturation, dysregulated aromatase P450 production affecting estrogen levels and follicular/oocyte development, and involvement of inflammatory cytokines such as TNF-α, IL-1β, IL-6, IL-8, and IL-10, alongside pelvic cavity, ovarian, and genetic factors. A major caveat stated is that the mechanisms linking endometriosis to infertility remain uncertain, with several competing theories rather than established certainty. This paper is centrally about endometriosis — it focuses on factors and mechanistic theories explaining endometriosis-associated infertility.

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Abstract

Endometriosis is a pathology that commonly prevails in more than 50% of women as a cause of dysmenorrhea and infertility and we can define it as the presence of endometrial glands and stroma outside of it, that is, ectopic endometrial tissue that is mostly located in the ovaries, Douglas pouch, uterosacral ligaments and other anatomical sites. Infertility associated with endometriosis is a multifactorial disease and there is no certainty about the mechanisms by which it is developed, however there are several theories that could provide an explanation. Oxidative stress is one of the factors that contribute to infertility where a chain of events is created that culminates in the alteration of the number of oocyte recovery and the number of mature oocytes. Dysregulation of aromatase P450 production in steroidogenesis causes a decrease in estrogen production altering follicular and oocyte development. There are also interleukins associated with infertility of which TNF-α, interleukin-1β, IL-6, IL-8, IL-10 and others stand out. On the other hand, there are several biological explanations that are related to the causal link between endometriosis and infertility, some of them include factors of the pelvic cavity, ovarian and genetic factors.
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Abstract

Endometriosis is a pathology that commonly prevails in more than 50% of women as a cause of dysmenorrhea and infertility and we can define it as the presence of endometrial glands and stroma outside of it, that is, ectopic endometrial tissue that is mostly located in the ovaries, Douglas pouch, uterosacral ligaments and other anatomical sites. Infertility associated with endometriosis is a multifactorial disease and there is no certainty about the mechanisms by which it is developed, however there are several theories that could provide an explanation. Oxidative stress is one of the factors that contribute to infertility where a chain of events is created that culminates in the alteration of the number of oocyte recovery and the number of mature oocytes. Dysregulation of aromatase P450 production in steroidogenesis causes a decrease in estrogen production altering follicular and oocyte development. There are also interleukins associated with infertility of which TNF-α, interleukin-1β, IL-6, IL-8, IL-10 and others stand out. On the other hand, there are several biological explanations that are related to the causal link between endometriosis and infertility, some of them include factors of the pelvic cavity, ovarian and genetic factors. Article Details This work is licensed under a Creative Commons Attribution 4.0 International License.

References

I. Tomassetti C, Hooghe T.. (2018). Endometriosis and infertility: Insights into the causal link and management strategies . Clinical Obstetrics and Gynaecology, 51, 25-33. II. Ferreira E, Innocenti V, Rodrigues J, et all. . (2019). Systemic oxidative stress as a possible mechanism underlying the pathogenesis of mild endometriosis-related infertility. RBMO, 39, 785-794. III. Michele Gomes Da Broi1, Rui Alberto Ferriani1,2, Paula Andrea Navarro1,2.(2019). Ethiopathogenic mechanisms of endometriosis-related infertility. JBRA Assisted Reproduction , 23, 273-280. October 21, 2020, From SpringerLink Database. IV. Michele Gomes Da Broi1 & Paula Andrea Navarro1. (2016). Oxidative stress and oocyte quality: etiopathogenetic mechanisms of minimal/mild endometriosis-related infertility. Cell Tissue Res, 364, 1-7. October 16, 2020, From Springer-Verlag Berlin Heidelberg Database. V. Miller J., Hyun Ahn S., Monsanto S., Khalaj K., Koti M., Tayade C. (2017) "Implications of immune dysfunction on endometriosis associated infertility" 8, (No. 4), pp: 7138-7147. VI. Pouly A, Gremeau S, Chauffour C, Brugnon F, Vorilhon S, Mestres S, Bourdel N, Matzusaki S and Chauvet P. (2020). Infertility and endometriosis. EMC - gynecology and obstetrics. 56(1), 1-10. VII. Sanchez A, Vanni V, Bartiromo L, Papeleo E, Zilberberg E, Candiani M, Orvieto R and Vigano P. (2017). Is the oocyte quality affected by endometriosis? A review of the literature. Journal of Ovarian Research. 10(43), 1-11. VIII. Nicolaus K, Brauer D, Sczesny R, Jimenez J, Buhler K, Hoppe I, and Runnebaum I. (2019). Endometriosis reduces ovarian response in controlled ovarian hyperstimulation independent of AMH, AFC, and women's age measured by follicular output rate (FORT) and number of oocytes retrieved. Archives of Gynecology and Obstetrics. 300. 1759-1765. IX. Nicolaus K, Brauer D, Sczesny R, Lehmann, Diebolder H and Runnebaum I. (2019). Unexpected coexistent endometriosis in women with symptomatic uterine leiomyomas is independently associated with infertility, nulliparity and minor myoma size. Archives of Gynecology and Obstetrics. 300. 103-108. X. Tanbo T., Fedorcsak P. (2017). "Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options" Acta Obstetricia et Gynecologica Scandinavica 96, pp: 659-667. XI. Panduro G and González L. (2017). Gynecology (4th ed). Guadalajara: Solución Impresa. XII. Cunningham G, Halvorson L, Bradshaw K, Schaffer J, Hoffman B and Schorge J (2014). Williams. Gynecology.(2 ed). Mexico: McGraw-Hill. XIII. Larry, J., Fauci A., Dennis K., Hauser S., Longo D., and Loscalzo J. (2019). Harrison: Principles of internal medicine. Vol. 1, 2 (20th ed.). Mexico: McGraw-Hill.

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endometriosisdysmenorrheainfertility

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