Endometriosis as a cause of infertility

underlying mechanisms and treatment perspectives

Abstract

Endometriosis is a chronic condition that impacts around 20% of women of reproductive age, resulting from the presence of endometrial tissue outside the uterine cavity, especially in the ovaries and peritoneal cavity. The exact cause of this disease is still unknown, and several theories exist in the literature to explain its pathophysiology, such as Sampson's Theory, which is known as the theory of retrograde menstruation. The main symptoms of the disease include pelvic pain and infertility. The difficulty in getting pregnant spontaneously is linked to the local inflammatory response caused by ectopic endometrial cells, leading to an increase in the levels of cytokines, interleukins, growth factors, angiogenic factors and defense cells. This unfavorable environment can affect physiological processes related to ovulation, fertilization and implantation, in addition to compromising sperm quality and causing anatomical changes in the female genital tract. The aim of this study was to compile the evidence available in current literature to understand the mechanisms related to infertility caused by endometriosis. It was found that inflammation is the fundamental factor that influences all processes that can affect fertility, and that research on the topic increases the prospects for developing new approaches for these patients.