Endometriosis, recurrent miscarriage and implantation failure: is there an immunological link?

Abstract

Endometriosis is more frequently diagnosed in patients with infertility than in a normal population. The goal of this paper is to give an overview of the clinical and fundamental evidence for a possible link between endometriosis and (recurrent) miscarriage or implantation failure after treatment with assisted reproductive technology. According to the literature, there is insufficient evidence for an association between endometriosis and (recurrent) miscarriage, but there is, however, epidemiological evidence to support the link between endometriosis and recurrent implantation failure after assisted reproduction. This can possibly be explained by alterations in humoral and cell-mediated immunity in women with endometriosis. Humoral immunological changes include increased formation of antibodies against endometrial antigens, anti-laminin-1 auto-antibodies and other auto-immune antibodies (e.g. antiphospholipid). Cell-mediated immunological changes include alterations in peritoneal and follicular fluid immune cells and cytokines. The possible negative effect of these immunological changes on folliculogenesis, ovulation, oocyte quality, early embryonic development and implantation in women with endometriosis suggests that infertility in endometriosis patients may be related to alterations within the follicle or oocyte, resulting in embryos with decreased ability to implant.

Role of hysterosalpingography and diagnostic laparoscopy in infertility

“…Tubal factors includes bilateral tubal blockage, unilateral tubal blockage, tubal scarring or other tubal problems like hydrosalpinx , tubal occlusion mass or peritubal adhesions. 14,15 Uterine factors includes mullerian anomalies, hypoplastic uterus, fibroid uterus and endometrial abnormalities. 16 Ovarian factors includes polycystic ovarian disease, streak ovaries, ovarian cysts.…”

“…17 Peritoneal factors includes endometriosis, pelvic adhesions and pelvic tuberculosis. 15 Standard infertility testing should be performed on all couples an if no other cause of infertility is found, then diagnosis of unexplained infertility may be considered.…”

Peripheral Biomarkers as Predictive Indicators of Endometriosis: A Prospective Case Control Study

“…Our study was supported by Ballard et al [16] endometriosis is the most frequent cause of deep dyspareunia, and patients with the disease have a 9-fold increase in risk of experiencing this symptom when compared with the general female population . In present study 56.7% subjects ( Table 2) had infertility (both primary and secondary), it was advocated by Tomassetti et al [17] that endometriosis can lead to anatomical distortions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury). On pelvic examination, the target indications of women with endometriosis differ as indicated by the area and size of injury.…”

Protein markers for external genital endometriosis

“…мы развития эндометриоза и связанного с ним бесплодия [19,20]. Уровень компонента С3 при III-IV стадиях эндомет-риоза в сыворотке крови возрастает на 23% (p=0,018) по сравнению с показателями в контрольной группе (см.…”