Endometriosis and its effects on assisted reproduction technologies

In conclusion, it appears that endometriosis impairs fertility even in cases of tubal patency. Proposed mechanisms range from toxic effects on gametes and embryos to alterations in tubal function and implantation. Possibly, the very process of altered host immune response, which allows ectopic endometrial implantation, adversely influences gamete interaction and/or embryo implantation. It is clear that assisted reproduction technologies remain an important treatment option for patients with endometriosis. The success of IVF is comparable to success rates reported in patients without the disease, GIFT results are more variable. Perhaps, different degrees of tubal disease or the presence of embryotoxic substances in the tubal mileu are responsible for the varying success rates reported with GIFT in these patients. Owing to the heterogeneity of endometriosis, its complex etiology and various manifestations, a precise identification and quantitation of its adverse effects in each individual case continues to prove challenging.