Whether or not so-called "mild" endometriosis affects fertility has remained controversial. At CHR, we strongly believe that endometriosis, even when mild, can negatively affect fertility. Even more importantly, endometriosis affects fertility adversely in many different ways, though its effects on normal tubal function appear to be the most important.
Investigations attempting to explain why patients with endometriosis often suffer from infertility have suggested that:
Finally, there may be an immunological factor involved in endometriosis. Norbert Gleicher, MD, CHR's Medical Director and Chief Scientist, was the first to report on the possible association of autoimmunity and endometriosis, suggesting that endometriosis, indeed, may be an autoimmune disease. It is now widely accepted that the immune system, indeed, plays an important role in endometriosis-associated infertility
Endometriosis appears to affect IVF adversely, from reducing the number of eggs at the time of retrieval to poorer egg quality, and lower implantation and pregnancy rates. However, most endometriosis patients will still be able to conceive with IVF.
Endometriosis often initially presents as "unexplained infertility," a diagnosis CHR does not believe in. Many studies in the literature point to similar patient characteristics in women with endometriosis and women with unexplained infertility. They also present with similar immune profiles.
In most cases of the so-called "unexplained infertility," we can pinpoint a real cause of infertility by performing appropriate diagnostic tests, even though correct diagnosis of endometriosis can be difficult. Correct diagnosis, of course, is the first step toward successful fertility treatment planning.
