Deep endometriosis may lead to infertility, but the mechanism is unclear and is associated with factors such as altered immune factors in the pelvic microenvironment. It has been suggested that 93.5% of patients with deep endometriosis have pelvic adhesions, thus affecting follicular production and tubal egg collection function and leading to infertility.
In addition, some studies have shown that the effect of ectopic endometriosis on fertility is more pronounced when it invades the bowel, which may be related to changes in pelvic anatomy caused by the invasion of the lesion into the recto-uterine trap, resulting in closure of the posterior trap.