Evaluating the Role of Autoimmunity in Endometriosis Patients

Fatemeh Davari Tanha, Zahra Kaveh, Maryam Marghoub, Mehrshad Abdoli, Ghazal Sahraeian, Razieh Akbari
In: Crescent Journal of Medical and Biological Sciences · 2026 · vol. 13(2) , pp. 77–82 · doi:10.34172/cjmb.2026.5052 · W7160780534
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This study found that infertile women with endometriosis had a higher prevalence of ANA, LAC, and anti-TPO antibodies and reduced ovarian reserve compared to infertile women without endometriosis.

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This case-control study compared 80 infertile women with endometriosis to 120 infertile controls without the condition to assess autoimmune markers and ovarian reserve. The researchers measured antinuclear antibodies, anti-thyroid peroxidase antibodies, lupus anticoagulant, and antiphospholipid antibodies alongside anti-Müllerian hormone levels. Results indicated significantly higher prevalence of ANA, LAC, and ATPO in the endometriosis group, which correlated with reduced oocyte counts and increased cycle numbers required for conception. This paper is centrally about endometriosis — specifically investigating the association between systemic autoimmunity and diminished ovarian reserve in affected patients.

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Abstract

Objectives: Endometriosis is a chronic inflammatory disease and one of the common causes of infertility in women. Increasing evidence suggests that the pathogenesis of endometriosis is not limited to hormonal changes, but also that immune dysregulation plays a key role. The present study aimed to investigate the presence of autoimmunity in the ovarian reserve of patients with endometriosis. Materials and Methods: In this case-control study, 200 women were selected between April 2024 and April 2025. Based on endometriosis, patients were split into two groups: 120 infertile women without endometriosis and 80 infertile women with endometriosis. All patients had blood samples measured for antibodies to antinuclear antibodies (ANA), to anti-thyroid peroxidase (ATPO), to lupus anticoagulant (LAC), and to antiphospholipid antibodies (APLA). Ovarian reserve was evaluated by measuring anti-Müllerian hormone (AMH). Clinical signs and disease severity were recorded. The data were analyzed using SPSS version 22, with a significance level of 0.05. Results: Patients were 34.95±5.6 years of age and had a body mass index (BMI) of 25.20±3.56 kg/m2. The Adhesion (P < 0.0001), sliding (P < 0.0001), kissing ovary (P < 0.001), and uterosacral involvement (P < 0.0001) were all significantly more frequent in the group with endometriosis. It showed that the prevalence of ANA (26.3% vs. 10.1%; P = 0.003), LAC (38.8% vs. 6.7%; P = 0.003), and ATPO (22.5% vs. 10.1%; P = 0.025) was significantly higher in the endometriosis group, while no difference was observed in APLA (P = 0.686). In patients with endometriosis, a significant decrease in oocyte count (P = 0.033) and a significant increase in cycle count (P = 0.045) were observed. Conclusions: In this study, comparing infertile women with those without endometriosis, a significantly higher prevalence of ANA, LAC, and anti-TPO antibodies was observed in women with endometriosis, along with reduced ovarian reserve indices. These findings indicate systemic immune involvement and suggest that ovarian dysfunction may be linked to autoimmune responses. Identification and follow-up of patients with positive antibody tests may therefore be important for fertility management and the prevention of declines in ovarian reserve.
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Mar 2026, Vol 13, Issue 2 Advanced Search For Author's & Reviewer's Poll How do you find the scientific quality of the published articles on our web site? | Original Article | | | Evaluating the Role of Autoimmunity in Endometriosis Patients | | | Fatemeh Davari Tanha1, Zahra Kaveh2, Maryam Marghoub1, Mehrshad Abdoli3, Ghazal Sahraeian1, Razieh Akbari4 | | | 11Department of Obstetrics and Gynecology, YAS Hospital, Tehran University of Medical Sciences, Tehran, Iran 2Department of Obstetrics & Gynecology & Reproductive Endocrinology of Women Hospital, Tehran University of Medical Sciences, Tehran, Iran 3Department of Obstetrics & Gynecology, Ardabil University of Medical Sciences, Ardabil, Iran 4Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran | | | CJMB 2026; 13: 077-082 DOI: 10.34172/cjmb.2026.5052 Viewed : 368 times Downloaded : 651 times. Keywords : Autoimmunity, Endometriosis, Immunology, Ovarian reserve | | | Full Text(PDF) | Related Articles | | | Abstract | | Objectives: Endometriosis is a chronic inflammatory disease and one of the common causes of infertility in women. Increasing evidence suggests that the pathogenesis of endometriosis is not limited to hormonal changes, but also that immune dysregulation plays a key role. The present study aimed to investigate the presence of autoimmunity in the ovarian reserve of patients with endometriosis. Materials and Methods: In this case-control study, 200 women were selected between April 2024 and April 2025. Based on endometriosis, patients were split into two groups: 120 infertile women without endometriosis and 80 infertile women with endometriosis. All patients had blood samples measured for antibodies to antinuclear antibodies (ANA), to anti-thyroid peroxidase (ATPO), to lupus anticoagulant (LAC), and to antiphospholipid antibodies (APLA). Ovarian reserve was evaluated by measuring anti-Müllerian hormone (AMH). Clinical signs and disease severity were recorded. The data were analyzed using SPSS version 22, with a significance level of 0.05. Results: Patients were 34.95±5.6 years of age and had a body mass index (BMI) of 25.20±3.56 kg/m2. The Adhesion (P < 0.0001), sliding (P < 0.0001), kissing ovary (P < 0.001), and uterosacral involvement (P < 0.0001) were all significantly more frequent in the group with endometriosis. It showed that the prevalence of ANA (26.3% vs. 10.1%; P = 0.003), LAC (38.8% vs. 6.7%; P = 0.003), and ATPO (22.5% vs. 10.1%; P = 0.025) was significantly higher in the endometriosis group, while no difference was observed in APLA (P = 0.686). In patients with endometriosis, a significant decrease in oocyte count (P = 0.033) and a significant increase in cycle count (P = 0.045) were observed. Conclusions: In this study, comparing infertile women with those without endometriosis, a significantly higher prevalence of ANA, LAC, and anti-TPO antibodies was observed in women with endometriosis, along with reduced ovarian reserve indices. These findings indicate systemic immune involvement and suggest that ovarian dysfunction may be linked to autoimmune responses. Identification and follow-up of patients with positive antibody tests may therefore be important for fertility management and the prevention of declines in ovarian reserve. | Cite By, Google Scholar Articles by Davari Tanha F Articles by Kaveh Z Articles by Marghoub M Articles by Abdoli M Articles by Sahraeian G Articles by Akbari R Articles by Fatemeh Davari Tanha Articles by Zahra Kaveh Articles by Maryam Marghoub Articles by Mehrshad Abdoli Articles by Ghazal Sahraeian Articles by Razieh Akbari Submit Paper Online Submission System CJMB ENDNOTE ® Style Tutorials Publication Charge Medical and Biological Research Center About Journal Online Submission System CJMB ENDNOTE ® Style Tutorials Publication Charge Medical and Biological Research Center About Journal Publication Information Publisher Aras Part Medical International Press Editor-in-Chief Arash Khaki Deputy Editor Zafer Akan Aras Part Medical International Press Editor-in-Chief Arash Khaki Deputy Editor Zafer Akan Published Article Statistics

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