Oocyte quality in endometriosis-associated infertility: a narrative analysis of mechanisms and therapeutic options

Lipsa Samal, Samal L, Chidananda Dash, Dash C, Pradhan S, Sujata Pradhan
Molecular biology reports · 2026 · vol. 53(1) · doi:10.1007/s11033-026-12714-w · PMID:42690563 · W7207735336
review OA: closed public-domain-us
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This narrative review examines how endometriosis impairs oocyte quality through inflammatory and oxidative mechanisms, reducing fertilization and blastocyst rates while noting that embryo transfer outcomes remain comparable to controls when high-quality embryos are utilized.

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Abstract

Endometriosis is a challenging gynaecological condition that can lead to infertility. This unique narrative review summarises the impact of endometriosis, focusing on oocyte quality, its subcellular and molecular mechanisms, clinical effects, and therapeutic options. The disease is associated with a hostile follicular microenvironment caused by inflammation, oxidative stress, granulosa and cumulus cell dysfunction, and hormonal dysregulation. It further leads to spindle disorders, mitochondrial DNA breakdown, and delayed cytoplasmic maturation. Women with stage III-IV endometriosis have low ovarian reserve, fewer retrieved and matured (MII) oocytes, and lower fertilisation and blastocyst development rates, resulting in worse cumulative pregnancy outcomes. However, when good-quality embryos are transferred, implantation and live birth rates are often similar to those of controls, suggesting that the problem is primarily oocyte-driven rather than endometrium-related. Therapeutic options include lifestyle modifications with a healthy diet, yoga, exercise, adequate sleep, and stress management, in addition to individualised assisted reproductive technology (ART) treatments, to enhance prognosis, though with sub-optimal proven mechanisms.

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MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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