Background: There is controversy related to pathogenesis and mechanism by which minimal or mild endometriosis affects fertility in women. It is accepted that moderate-severe endometriosis disrupt the anatomical relationships between fallopian tube and ovary. Some researchers found impaired implantation in patients with endometriosis, but such defects in implantation may be caused by either embryos or altered endometrium. Further investigations on follicular fluids have also found differences between women with endometriosis and women without the disease. In addition, recent advances on implantation research, show features in the eutopic endometrium of women with endometriosis that are not found in endometrium of women without the disease, although it is controversial. The review aims at describing the available information from the eutopic endometrium or embryo standpoint infertility related to endometriosis. Objective: To explore the interrelation of the eutopic endometrium or embryo in women with infertility and the endometriosis. Methods: Retrospective review of literature using all the available English databases, Cochrane register and articles which addressed the question "Whether the endometrium or embryo quality is different in women with endometriosis associated infertility?" Conclusion: Although contradictory results have been reported, different clinical studies have demonstrated worse success rates for pregnancy in women with endometriosis compared with healthy women or with tubal factor among those that found lower pregnancy rates in women with endometriosis compared with controls without the disease, some found alterations in implantation rates in women with endometriosis when they were compared with controls. The debate continues, and other approaches should be developed before we can determine the authentic origin of the defects that make conception more difficult in these patients. These new studies must include an adequate design and controls, in order to avoid misleading data that can complicate the interpretation of the pathophysiology of this enigmatic disease. TCM-GMJ September 2017; 2(2):P24-P27)
Background: Information about the prevalence of fallopian tube pathology in the early stages of endometriosis is scarce. The aim of our study was to examine the association between genital endometriosis and the lengths of fallopian tubes in infertile women. Settings and Design: retrospective cohort study. Methods: We studied 651 infertile patients in the 20-40 year age group, who visited a Reproductive Clinic for treatment between 2012-2018. After laparoscopy, endometriosis (detected by histomorphology) was indicated in 472 cases and absent in 179 cases. The length of the fallopian tubes was estimated in 193 primary infertile women with endometriosis. We excluded patients from the study who had surgical intervention on their tubes. Appearance of tubes and fimbriae was assessed in 177 patients without endometriosis and in 461 patients with endometriosis. Results: The proportion of women with shorter (<8 cm) right and left fallopian tubes was significantly greater in those with endometriosis. Conversely, the proportion of women with longer (>12 cm) left fallopian tubes was significantly higher in the group of patients without endometriosis. Correlation analysis showed significant positive correlations of endometriosis with: a short (<8 cm) right fallopian tube-r = -0.504** (p < 0.001); Significant negative correlationsof endometriosis were with: a medium (8-12 cm) length right fallopian tube-r = -0.639** (p < 0.001); a long (>12 cm) left fallopian tube-r = -0.596** (p < 0.001); Conclusions: Infertile women with minimal or mild endometriosis have been shown to have anatomical and structural changes in the fallopian tubes and fimbriae compared to those without endometriosis. The presence of genital endometriosis (I;II stage) maybe associated with shorter fallopian tubes.
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