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A Journal on Obstetrics and Gynecology

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Minerva Ginecologica 2013 April;65(2):181-98

language: English

From conception to birth - How endometriosis affects the development of each stage of reproductive life

Carvalho L. F. P. 1, 2, Rossener R. 1, Azeem A. 1, Malvezzi H. 1, 3, Abrão M. S. 2, Agarwal A. 1, 3

1 Center for Reproductive Medicine, Obstetrics and Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH, USA;
2 Department of Obstetrics and Gynecology, São Paulo University, São Paulo, Brazil;
3 Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA


Increasing evidence suggests that female infertility is associated with endometriosis. Indeed, 40% of women with this disease are infertile. However, a causal relationship has not yet been established, and the possible pathophysiology of infertility in this disease also has not been completely elucidated. In this article, we analyze the mechanisms necessary to achieve a successful live birth in patients with this disease as well as the important steps of fertility, pregnancy and birth that can be impaired in these women. Specifically, we will review new advances in research on folliculogenesis, oocyte quality and sperm quality, egg fertilization, embryo quality, transport through fallopian tube and utero-tubal transport sperm, implantation defects, risk of miscarriage, risk during pregnancy and pre-term delivery. The physiopathology of these alterations and the clinical results of the studies are still very controversial. For these reasons, we can conclude that more research is needed to study the biological pathways of the fertility impairment caused by this disease.

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