Endometriosis and infertility: pathophysiology, treatment strategies, and reproductive outcomes

IF 2.5 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Archives of Gynecology and Obstetrics Pub Date : 2025-07-21 DOI:10.1007/s00404-025-08124-1

Shai E. Elizur, Jollanar Mostafa, Elad Berkowitz, Raoul Orvieto

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引用次数: 0

Abstract

Endometriosis is a chronic gynecological disorder characterized by ectopic endometrial-like tissue, leading to pain, dysmenorrhea, and infertility. This review explores classification systems, the mechanisms of endometriosis-related infertility, and the impact of endometriosis subtypes on fertility outcomes. Medical therapies, such as hormonal suppression, alleviate symptoms but are unsuitable for women who wish to conceive. Surgery may enhance natural conception rates in select cases but may have a negative impact on ovarian reserve. Assisted reproductive technologies, such as intrauterine insemination and in vitro fertilization, provide effective fertility treatments. However, endometriosis can negatively affect oocyte quality and implantation rates.

Given the complexity of endometriosis and its varying impact on fertility, a personalized, multidisciplinary approach is recommended. This review proposes an updated treatment algorithm that integrates clinical, imaging, and other infertility causes to optimize treatment outcomes. Future research is needed for refining classification systems and indications for fertility-preservation treatments, as well as improving assisted reproductive technology success rates.

查看原文本刊更多论文

子宫内膜异位症和不孕症：病理生理学、治疗策略和生殖结果。

子宫内膜异位症是一种慢性妇科疾病，其特征是子宫内膜样组织异位，导致疼痛、痛经和不孕。本文综述了子宫内膜异位症的分类系统、机制以及子宫内膜异位症亚型对生育结果的影响。药物治疗，如抑制激素，可以减轻症状，但不适合希望怀孕的妇女。在某些情况下，手术可以提高自然受孕率，但可能对卵巢储备产生负面影响。辅助生殖技术，如宫内人工授精和体外受精，提供了有效的生育治疗。然而，子宫内膜异位症会对卵母细胞质量和着床率产生负面影响。考虑到子宫内膜异位症的复杂性及其对生育能力的不同影响，建议采用个性化的多学科方法。这篇综述提出了一种更新的治疗算法，将临床、影像学和其他不孕原因整合在一起，以优化治疗结果。未来的研究需要完善分类系统和生育保护治疗的适应症，以及提高辅助生殖技术的成功率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Gynecology and Obstetrics 医学-妇产科学

CiteScore

4.70

自引率

15.40%

发文量

493

审稿时长

1 months

期刊介绍： Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.