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by claude@2026-06, 2026-06-07
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This review analyzes endometriosis-associated infertility and finds that 3-6 months of hormone suppressive therapy, particularly with dienogest, before IVF may improve pregnancy outcomes by modulating inflammation and enhancing oocyte and embryo quality.
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by claude@2026-06, 2026-06-07
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This analytical literature review examines endometriosis-associated infertility, focusing on proposed mechanisms (including pelvic adhesions and fallopian tube obstruction, as well as proinflammatory cytokine effects that may impair endometrial receptivity and oocyte quality) and the role of hormone therapy prior to in vitro fertilization (IVF). It summarizes epidemiologic context and notes that endometriosis interferes with multiple reproductive steps and is linked to lower IVF success rates, while the exact infertility mechanisms remain largely unclear. The authors conclude that long-term (3–6 months) hormone suppressive therapy before IVF may improve outcomes and that preliminary dienogest use is repeatedly reported to enhance clinical pregnancy and live birth rates and improve oocyte, embryo, and blastocyst parameters, with effects attributed to favorable changes in systemic and local inflammatory microenvironments; a key caveat is that the work is a narrative review with acknowledged uncertainty about underlying mechanisms. This paper is centrally about endometriosis — it reviews endometriosis-associated infertility and hormone-therapy approaches (notably dienogest) in preparation for IVF.
Abstract
Objective. Analytical review of the literature on endometriosis-associated infertility, its mechanisms and hormone therapy in preparation for in vitro fertilization (IVF). Endometriosis is considered the most common benign but potentially metastatic gynecological disease and occurs in approximately 10% of women of reproductive age, causing infertility in 40%. Patients with this disease often require the use of assisted reproductive technologies to increase the chances of pregnancy. However, endometriosis interferes with all aspects of the reproductive process and is associated with lower success rates than other indications for IVF. The mechanisms of infertility associated with endometriosis remain largely unknown. Several etiological factors of endometriosis-associated infertility are discussed, ranging from abnormal anatomy and fallopian tube obstruction due to pelvic adhesions to less studied factors such as proinflammatory cytokine responses leading to endometrial receptivity and impaired oocyte quality. Conclusion. To improve IVF outcomes in infertile patients with endometriosis, a long-term (3–6 months) hormone suppressive therapy before the cycle was suggested. Preliminary prescription of dienogest may improve clinical outcomes of pregnancy after IVF in patients with this disease. Dienogest has a favorable effect on both systemic and local inflammatory microenvironment, increases the number and quality of obtained oocytes, high-quality embryos and blastocysts, the rate of clinical pregnancy and live birth, which has been repeatedly shown in studies. Key words: endometriosis, IVF, IVF failure, dienogest, infertility
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Endometriosis-associated infertility: pathogenesis and possibilities of hormone therapy in preparation for IVF
Mekan R.Orazov /
Victor E. Radzinsky /
Roman E. Orekhov /
Marina B. Tairova /
Objective. Analytical review of the literature on endometriosis-associated infertility, its mechanisms and hormone therapy in preparation for in vitro fertilization (IVF). Endometriosis is considered the most common benign but potentially metastatic gynecological disease and occurs in approximately 10% of women of reproductive age, causing infertility in 40%. Patients with this disease often require the use of assisted reproductive technologies to increase the chances of pregnancy. However, endometriosis interferes with all aspects of the reproductive process and is associated with lower success rates than other indications for IVF. The mechanisms of infertility associated with endometriosis remain largely unknown. Several etiological factors of endometriosis-associated infertility are discussed, ranging from abnormal anatomy and fallopian tube obstruction due to pelvic adhesions to less studied factors such as proinflammatory cytokine responses leading to endometrial receptivity and impaired oocyte quality.
Conclusion. To improve IVF outcomes in infertile patients with endometriosis, a long-term (3–6 months) hormone suppressive therapy before the cycle was suggested. Preliminary prescription of dienogest may improve clinical outcomes of pregnancy after IVF in patients with this disease. Dienogest has a favorable effect on both systemic and local inflammatory microenvironment, increases the number and quality of obtained oocytes, high-quality embryos and blastocysts, the rate of clinical pregnancy and live birth, which has been repeatedly shown in studies.
Key words: endometriosis, IVF, IVF failure, dienogest, infertility
For citation: Orazov M.R., Radzinsky V.E., Orekhov R.E., Tairova M.B. Endometriosis-associated infertility: pathogenesis and possibilities of hormone therapy in preparation for IVF. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2022; 21(2): 90–98. (In Russian). DOI: 10.20953/1726-1678-2022-2-90-98
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