Endometriosis and Implantation Failure: Review

Emine Emsal DEMİREL, Sefa KELEKÇİ, Serpil Aydoğmuş, Nihan KIZILTUĞ, Serenat ERİŞ, Serenat Eriş Yalçın
In: Turkiye Klinikleri Journal of Gynecology and Obstetrics · 2015 · vol. 25(2) , pp. 111–116 · doi:10.5336/gynobstet.2013-38162 · W1533381213
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This review explores the complex relationship between endometriosis and implantation failure, highlighting the need for better understanding of endometrial receptivity and biomolecular mechanisms.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 ⓘ

This narrative review discusses the relationship between endometriosis and implantation failure, focusing on endometrial receptivity, molecular/morphological markers, and how these might contribute to subfertility in populations undergoing assisted reproduction. It summarizes evidence that while the association between advanced endometriosis and subfertility is clearer, mechanisms in early-stage disease are less well established; additionally, several studies in IVF report lower fertilization and implantation rates in early-stage endometriosis versus tubal factor controls. The review argues that implantation is a complex, time-limited process requiring embryo quality, a receptive endometrium, and appropriate embryo–endometrium communication, and it notes that donor oocyte models are not ideal because recipient cohorts often represent older patients with premature ovarian insufficiency and may not generalize to endometriosis populations. This paper is centrally about endometriosis—its specific focus is endometriosis-associated endometrial receptivity and implantation failure in subfertility/IVF outcomes.

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Abstract

Endometriyoz, östrojen bağımlı kronik inflamatuar bir hastalıktır. Endometriyoz doğurgan çağdaki kadınların yaklaşık %7'sinde, oral kontraseptiflere yanıt vermeyen kronik pelvik ağrısı olan grubun yaklaşık olarak %70'inde, subfertil gruptaki kadınların ise yaklaşık %50'sinde saptanır. Kesin tanısı için invaziv bir işlem olan laparoskopi işlemi gerektiğinden tüm popülasyon için kesin bir insidans rakamı vermek zordur. Endometriyoz ile subfertilite arasında güçlü bir birliktelik olduğu genel kabul gören bir kavramdır. İleri evre endometriyoz ve subfertilite ilişkisi net kurulabilirken, erken evre endometriyoz için sebep-sonuç ilişkisi bu kadar açık değildir. Endometriyoz ile subfertilite arasındaki sebep-sonuç ilişkisini açıklamak için yapılan ilginç oosit donasyon modellerinde sorumlu oosit gibi görünmesine karşın endometriyumun sorunsuz olmadığı bir gerçektir. Bununla birlikte donör oosit modelleri bu birlikteliği açıklamak için ideal bir model değildir. Çünkü donör oosit modelleri kohort açısından incelendiğinde ileri yaş ve prematür over yetmezliği olan gruptur ve bunlardan elde edilen sonuçlar tümüyle endometriyoz gruplarına uygulanamaz. Başarılı bir gebeliğin olmazsa olmazı olan implantasyon oldukça kompleks bir olaylar zinciridir. İmplantasyon başarısızlığının altta yatan biyomoleküler mekanizmaları çözüldükçe endometriyozda implantasyon sorunları daha anlaşılır hale gelmektedir. Son zamanlardaki çok sayıda genomik bazlı mikro dizilim çalışmalarına karşın ideal endometriyal reseptivite belirteci henüz mevcut değildir. Endometriyal reseptivite probleminin altta yatan fizyopatolojisinin çözülmesi hem tekrarlayan implantasyon başarısızlıklarında hem de açıklanamayan subfertilite yönetiminde yeni ufuklar açacaktır. Endometriosis is a chronic estrogen-dependent inflammatory disease. Endometriosis can be detected in approximately 7% of women in reproductive period, 70% in the group with chronic pelvic pain unresponsive to oral contraceptives and approximately 50% of subfertile women. It is difficult to give a precise incidence for the entire population as because an invasive laparoscopic procedure is required for the accurate diagnosis. A clear relationship has been established between advanced endometriosis and subfertility. However, it remains unclear whether early stage endometriosis is associated with subfertility. Although studies performed using oocyte donation models suggested that oocytes were responsible for this effect, it is clear that the endometrium is affected in patients with endometriosis. The implantation which is necessary for succesful pregnancy is a complex chain of events. When oocyte donor models were examined for cohort, it is seen that patients in the advanced age and with premature ovarian failure generates this group, and the results obtained from them entirely not applicable to the endometriosis group. A clear understanding of the biomolecular mechanisms that underlie implantation failure will facilitate the study of implantation problems in patients with endometriosis. Despite so many recent genomic microarray-based studies, ideal endometrial receptivity markers are not yet available. New horizons will be open for managing recurrent implantation failure and unexplained subfertility by solving the underlying pathophysiology of the problem of endometrial receptivity.

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Condition tags

endometriosischronic_pelvic_pain

Citation neighborhood

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.

References (43)

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