ENDOMETRIOSIS- WHAT ARE THE MECHANISMS RESPONSIBLE FOR INFERTILITY
Corresponding author:
[email protected]
Accepted
29 March 2026
Available Online
20 July 2019
Abstract
INTRODUCTION: ENDOMETRIOSIS IS ONE OF THE MOST IMPORTANT CAUSES OF INFERTILITY IN
REPRODUCTIVE AGE PATIENTS, BUT WHAT ARE THE MECHANISMS INVOLVED? THIS ARTICLE
DESCRIBES STEP BY STEP THE PSYSIOPATHOLOGY BACKGROUND THAT LEADS TO PREGNANCY
ACHIEVING IMPAIRMENT.
METHODS: WE PERFORMED A REVIEW OF THE INTERNATIONAL SPECIALTY LITERATURE.
RESULTS: ENDOMETRIOSIS DETERMINES MODIFICATION OF NEOANGIOGENESIS AND CELLULAR
MEDIATED RESPONSE BY HIGH CONCENTRATIONS OF INFLAMMATORY CYTOKINES (IL1, IL6, TNF
ALPHA, PROSTAGLANDIN, PROTEASES) AND ANGIOGENIC FACTORS (IL8 AND VEGF). THESE CAUSE
ALTERATION OF THE PELVIC ANATOMY AND, IN ADDITION TO LOWERING ΑVΒ3 INTEGRIN ADHESION
MOLECULE AND THE L-SELECTIN LIGAND, CONTRIBUTES TO ASSOCIATED IMPLANTATION FAILURE.
NEVERTHELESS, OVULATION IMPAIRMENT BY MECHANICAL DISTRUCTION OR ALTERATION OF
GRANULLAR CELLS FUNCTION WITH ESTROGEN AND PROGESTERONE SECRETION DEFICIENCY AND
LUTEAL PHASE MODIFICATIONS HAVE A FERTILITY NEGATIVE IMPACT. THE EMBRYOTOXICITY EFFECT
COMES IN ADDITION TO THIS WITH AN INCREASED ABORTION RATE. ALTERATION OF SPERMATOZOA
MOBILITY AND ENDOMETRIAL RECEPTIVITY, INCREASED UTERINE CONTRACTILITY AND FALLOPIAN
TUBES OBSTRUCTION COMPLETE THE PICTURE OF INFERTILITY IN THE ENDOMETRIOSIS PATIENT.
CONCLUSIONS: ENDOMETRIOSIS AFFECTS FERTILITY THROUGH MULTIPLE MECHANISMS, AND IN
ORDER TO TREAT AND GET PREGNANCY IN THESE PATIENTS, IT IS NECESSARY TO UNDERSTAND THEM.
Keywords
ENDOMETRIOSIS
INFERTILITY
IMPLANTATION
EMBRIOTOXICITY
INFLAMMATORY
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