Implications of immune dysfunction on endometriosis associated infertility

Abstract

Endometriosis is a complex, inflammatory disease that affects 6-10% of reproductive-aged women. Almost half of the women with endometriosis experience infertility. Despite the excessive prevalence, the pathogenesis of endometriosis and its associated infertility is unknown and a cure is not available. While many theories have been suggested to link endometriosis and infertility, a consensus among investigators has not emerged. In this extensive review of the literature as well as research from our laboratory, we provide potential insights into the role of immune dysfunction in endometriosis associated infertility. We discuss the implication of the peritoneal inflammatory microenvironment on various factors that contribute to infertility such as hormonal imbalance, oxidative stress and how these could further lead to poor oocyte, sperm and embryo quality, impaired receptivity of the endometrium and implantation failure.

Endometrial receptivity in the eutopic endometrium of women with endometriosis: it is affected, and let me show you why

“…These inflammatory responses of the endometrium of endometriosis has important downstream effects that impact fertility (85-90) and have been recently reviewed (5, 91). Interleukin-17 is central to many of the changes in endometriosis including the stimulating effect on cyclooxygenase-2 (Cox-2) activity, IL-8 and aromatase expression (92).…”

Effect of Etanercept on the Success of Assisted Reproductive Technology in Patients with Endometrioma

“…Any problem in these systems, such as endometriosis-induced inflammation, impairs reproductive function [18]. Endometriosis characteristically causes chronic intraperitoneal inflammation and may cause infertility by several pathways, including disturbed folliculogenesis, reduced oocyte quality, impaired embryo development, and reduced endometrial receptivity [19, 20].…”

“…Progesterone acts through progesterone receptors A and B. Reduced progesterone B receptors disrupt adequate progesterone signaling and this causes progesterone resistance, which is a hallmark for implantation failure [18]. A previous study showed that TNF-α caused a decrease in progesterone A and B receptor expression in the endometrium in women with endometriosis [21].…”

Phytotherapeutische Behandlungsmöglichkeiten bei Endometriose-Erkrankungen

“…Die Endometriose wird als eine proliferativ-entzündliche Erkrankung angesehen [2,11]. Ätiologisch wird eine biochemische Prägung während der Schwangerschaft und perinatal diskutiert [12,13].…”

“…Eine Belastung mit Xeno-Östrogenen ist mit Endometriose und Myomata korreliert [10,14]. Mit Beginn der Pubertät wird eine Entzündungskaskade ausgelöst, die über die Estradiol-Produktion gesteuert ist [2,[15][16][17][18]. Die biochemische Dysbalance führt oft zu Funktionsstö-rungen wie chronischen Schmerzen sowie Tubentransport-und Einnistungsproblemen.…”