Is endometrial receptivity in women with endometriosis negatively affected? Insights from IVF frozen embryo transfer cycles

Giorgia Di Stefano, Mathilde Bourdon, Maíra Casalechi, Roberta Bellinghieri, Marco Reschini, Paola Viganò, Piétro Santulli
In: Journal of Endometriosis and Uterine Disorders · 2026 · vol. 16 , pp. 100185 · doi:10.1016/j.jeud.2026.100185 · W7211941860
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This paper investigates whether endometrial receptivity is negatively affected in women with endometriosis by analyzing data from IVF frozen embryo transfer cycles.

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Abstract

Introduction Endometriosis is a major cause of infertility, and Assisted Reproductive Techniques (ART) represent an effective approach for managing infertility associated with this condition. Because ART cycles allow direct evaluation of implantation outcomes, they provide a useful framework for assessing the specific impact of endometriosis on endometrial receptivity. Material and methods In this retrospective matched case-control study, we aimed to investigate the effect of endometriosis on endometrial receptivity using a design that minimizes the influence of ovarian and anatomical factors associated with the disease. A total of n = 195 women with peritoneal, ovarian and/or deep endometriosis were included and matched 1:1 with controls according to age and the number and morphological quality of cryopreserved blastocysts. All participants underwent a freeze-all ART cycle between September 2016 and September 2018 at the Reproductive Medicine Unit of Cochin Hospital and were evaluated according to the Core Outcome Measures for Infertility Trials recommendations. Results The cumulative clinical pregnancy rate was similar in women with and without endometriosis (62% vs 61%, crude OR 1.02, 95% CI 0.68–1.54; P = 0.92). After adjustment for variables that differed between groups (BMI, total number of retrieved oocytes and fertilization method), the OR was 1.25 (95% CI 0.79–2.00; P = 0.34). The cumulative live birth rate was also similar between groups (48% vs 49%, P = 0.84). Conclusions Our findings suggest that, in affected patients, endometriosis does not significantly impair endometrial receptivity.

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