Reproductive Outcomes in Infertile Women with Endometriosis Undergoing Assisted Reproductive Technology

Background:Endometriosis-related infertility and its treat-ment with assisted reproductive technologies (ART) havebeen broadly researched. Yet, underlying mechanisms ofinfertility, particularly in the absence of tubal dysfunction,remain unclear. While the impact of inflammatory milieu onthe ovary and/or endometrium has been indicated as acontributing factor, recent evidence from euploid transfersand donor cycles questions the extent of these effects.Moreover, the frequent coexistence of other confounders,such as adenomyosis, further complicates the clinical pic-ture, making it difficult to isolate the specific impact ofendometriosis on ART outcomes.Objectives:The aim of thestudy was to evaluate the influence of endometriosis onvarious aspects of ART, including oocyte competence, ARTsuccess, and whether surgical or medical treatments im-prove these.Methods:We primarily focused on recent high-quality sources, including systematic reviews, large-scaleobservational studies, and meta-analyses, to provide a ro-bust and reliable synthesis of the available evidence.Outcome:While oocyte yield can decrease in the presenceof an endometrioma or history of endometrioma excision,oocyte quality, early embryo development indicators, an-euploidy rates, and clinical outcomes of endometriosis pa-tients do not differ from other infertility diagnoses in ARTsetting. Surgical treatments and hormonal suppressionbefore ART do not seem to improve outcomes. Ovarianstimulation for ART does not exacerbate endometriosissymptoms.Conclusions and Outlook:Endometriosis, de-spite its high prevalence among infertile patients, does notinherently impair ART success, except in cases where ovarianreserve is compromised due to ovarian disease or its surgicaltreatment. The causal link between endometriosis and in-fertility remains an enigma, and future studies shouldcontinue to explore this association with other confoundingfactors.(c) 2025 S. Karger AG, Basel