Is the oocyte quality affected by endometriosis? A review of the literature

Abstract

Endometriosis is an estrogen-dependent chronic inflammatory condition that affects women in their reproductive period causing infertility and pelvic pain. The disease, especially at the ovarian site has been shown to have a detrimental impact on ovarian physiology. Indeed, sonographic and histologic data tend to support the idea that ovarian follicles of endometriosis patients are decreased in number and more atretic. Moreover, the local intrafollicular environment of patients affected is characterized by alterations of the granulosa cell compartment including reduced P450 aromatase expression and increased intracellular reactive oxygen species generation. However, no comprehensive evaluation of the literature addressing the effect of endometriosis on oocyte quality from both a clinical and a biological perspective has so far been conducted. Based on this systematic review of the literature, oocytes retrieved from women affected by endometriosis are more likely to fail in vitro maturation and to show altered morphology and lower cytoplasmic mitochondrial content compared to women with other causes of infertility. Results from meta-analyses addressing IVF outcomes in women affected would indicate that a reduction in the number of mature oocytes retrieved is associated with endometriosis while a reduction in fertilization rates is more likely to be associated with minimal/mild rather than with moderate/severe disease. However, evidence in this field is still far to be conclusive, especially with regards to the effects of different stages of the disease and to the impact of patients’ previous medical/surgical treatment(s).

Back to life from frozen state

“…It has been shown that the number of eggs retrieved are less in patients with endometriosis compared to patients without such disease. There is no conclusive data with regard to fertilization and embryo quality in patients with different stages of endometriosis 26 .…”

Increasing Trends in Deep Infiltrating Endometriosis (DIE) with Bilateral Endometrioma from Adolescence till Menopause

“…Microsurgical techniques with careful and precise dissection should be practised to cause minimal trauma, tissue ischaemia, inflammation and adhesion formation 15 . Women with infertility and DIE and endometrioma of more than 5cms should proceed for conservative surgical resection of implants followed by IVF as these women with advanced disease have decreased ovarian reserve, poor oocyte and poor embryo quality with poor implantation 16 . Prolonged GnRH agonists given prior to IVF, improves results in cases with stage 4 endometriosis 17 .…”

Cellular and molecular changes associated with fish oocyte ageing

“…Advancing maternal age is a well‐recognized factor influencing the occurrence the spindle abnormalities (Sanchez et al . ). However, this has not yet been studied with fish post‐ovulatory oocyte ageing.…”