Ovarian Function
Ovulation failure
abnormal follicle development
Failure to ovulate – but this is a common cause of infertility whether or not you have endometriosis.
In some patients with endometriosis, the follicles in the ovaries do not grow at a normal rate. The exact cause is not known.
Unruptured follicular luteinization syndrome (LUFS)
In patients with unruptured follicular luteinization syndrome, the follicles develop normally but the eggs are not released properly after a peak of luteinizing hormone, usually detected during laparoscopy or ultrasonography.
Oocyte abnormalities
It was once thought that the quality of eggs was reduced in patients with endometriosis, which could explain the low success rate of assisted reproduction (IVF) in patients with endometriosis. However, current studies show that IVF success rates are not low in patients with mild to moderate endometriosis.
Sperm and egg transport
Abnormal Fallopian tube function
Some related substances, such as prostaglandins produced by endometrial tissue, can affect the motor function of the muscles and cause infertility if the delivery of eggs or fertilized eggs is impaired.
Abnormalities in the anatomy of the fallopian tubes
Pelvic inflammatory disease caused by endometriosis leads to adhesions between the fallopian tubes and the surrounding pelvic organs, changes in the normal anatomy or adhesions in the inner wall of the fallopian tubes, or fibrosis in the wall of the fallopian tubes due to inflammation, all of which can lead to obstruction of egg or fertilized egg transport.
Reduced sperm viability
The inflammatory response caused by endometriosis increases the number of macrophages in the reproductive tract, which can attack sperm cells and reduce their viability in the body.
Implantation
Endometrial insufficiency
The endometrium of patients with endometriosis often lacks the factors associated with helping the fertilized egg to implant in the endometrium during the luteal phase.
Immune factors
Increased number and activity of peritoneal fluid macrophages
Increased number and activity of multiple cytokines in the peritoneal fluid of patients with endometriosis affect sperm viability, egg maturation, sperm-egg binding, fertilized egg survival, and tubal function.
Increased endometrial cytokine activity
Several related factors, such as C3 complement, HOXA10, HOXA11, and HGF, can affect fertilized egg implantation and development.