Endometriosis-Related Infertility: Focus on Oocyte Quality
Apr 4, 2025
Oocyte Quality Impairment as a Key Contributor to Endometriosis-Related Infertility
Key Points
Importance:
- Clarifying how endometriosis impairs oocyte quality is critical for improving fertility outcomes and guiding effective treatment strategies in reproductive medicine.
Highlights:
- Endometriosis negatively impacts oocyte quality, leading to reduced fertilization, embryo development, and pregnancy success.
- Structural and molecular abnormalities in oocytes are key contributors to infertility in affected women.
What's done here:
- This review by Dr.Fan and colleagues synthesizes current evidence on the mechanisms by which endometriosis affects oocyte quality and contributes to infertility.
- It examines cellular and molecular mechanisms including oxidative stress, cytokine imbalance, hormonal dysregulation, and lipid metabolism.
- It also evaluates diagnostic challenges and therapeutic approaches including surgery, hormonal treatment, and antioxidants.
Basic outlines:
- Endometriosis-associated infertility is linked to altered secretion of reactive oxygen species, cytokines, lipids, and steroid hormones, which collectively impair oocyte quality.
- Treatment aims to alleviate symptoms while preserving fertility and optimizing outcomes through assisted reproductive technologies.
- Surgical removal of endometriotic lesions can reduce inflammation and improve pelvic pain, potentially enhancing oocyte environment and quality.
- Pre-treatment with GnRH antagonists before IVF has shown to improve oocyte quality and endometrial receptivity, leading to better fertility outcomes.
- Emerging evidence supports the use of antioxidants—including vitamins C and E, melatonin, resveratrol, xanthohumol, N-acetyl-L-cysteine, and astaxanthin—as potential adjunct therapies to mitigate oxidative stress and improve oocyte quality.
Lay Summary
Fertility and pregnancy success depend on three key factors: the number of oocytes, ovulation, and oocyte quality. While tests such as anti-Müllerian hormone levels and antral follicle counts can estimate oocyte quantity and ovulation, oocyte quality can only be assessed during in vitro fertilization. Research has shown that women with endometriosis often experience lower rates of oocyte maturation, fertilization, embryo development, and implantation, along with a higher risk of miscarriage.
Improving oocyte quality is therefore a critical step before initiating IVF in women with endometriosis.
In a recent review published in Archives of Gynecology and Obstetrics, Fan et al. from Zhejiang Chinese Medical University, China, examined current evidence on the biological mechanisms and treatment strategies related to poor oocyte quality in endometriosis.
The review highlights that endometriosis can alter ovarian function, leading to reduced follicle count, abnormal follicle development, and structural changes in oocytes, such as dark cytoplasm and fragmented polar bodies—all of which may impair fertility. These changes are thought to be caused by disruptions in the follicular environment, including imbalances in reactive oxygen species, cytokines, lipids, and hormones.
Although multiple studies have explored these mechanisms, more large-scale research is needed to confirm how endometriosis affects oocyte quality at the cellular and molecular levels.
There is currently no universally accepted treatment plan, but the review discusses several promising approaches. These include surgical removal of endometriotic lesions, hormone therapy, and antioxidant treatments—all of which may help improve oocyte quality and IVF outcomes.
This important review emphasizes the need for personalized treatment and further research to improve fertility care for women with endometriosis.
Research Source: https://pubmed.ncbi.nlm.nih.gov/39891673/
oocyt therapeutic strategy mechanism invitro fertilization infertility pelvic pain dysmenorrhea endometriosis.