Abstract：
How endometriosis causes infertility, with the exception of tubal dysfunction caused by adhesions, is unclear. The inflammatory milieu in the pelvis and impaired receptivity of the eutopic endometrium are considered to be possible factors. Anatomical staging systems fail to predict the fertility status of endometriosis patients. Data from assisted reproductive technology cycles consistently suggest that oocytes from patients with endometriosis have a normal potential to develop into euploid blastocysts. Moreover, oocyte or embryo recipients with endometriosis seem to have similar or slightly lower pregnancy and live birth rates compared with recipients without endometriosis, suggesting that eutopic endometrium is not or is only minimally affected, which may be caused by undiagnosed adenomyosis. In-vivo observations from women with endometriomas provide evidence against a detrimental effect of endometriomas on oocytes. Combined with the absence of an obvious improvement in fertility following the surgical destruction or excision of peritoneal endometriosis or from temporary medical suppression of the disease and the associated inflammation, the available evidence makes endometriosis-associated infertility questionable in the absence of tubal dysfunction caused by adhesions. It is likely that no anatomical staging will correlate with fertility beyond assessing tubal function. In patients with endometriosis assisted reproductive technology is as effective as for other indications.
摘要：
子宫内膜异位症如何导致不孕，除了由粘连引起的输卵管功能障碍，不清楚。骨盆的炎症环境和在位子宫内膜的容受性受损被认为是可能的因素。解剖分期系统无法预测子宫内膜异位症患者的生育状况。来自辅助生殖技术周期的数据一致表明，子宫内膜异位症患者的卵母细胞具有发育为整倍体胚泡的正常潜力。此外，与没有子宫内膜异位症的受者相比，患有子宫内膜异位症的卵母细胞或胚胎受者似乎具有相似或略低的妊娠率和活产率。表明在位子宫内膜不受影响或仅受影响最小，这可能是由未确诊的子宫腺肌病引起的。来自患有子宫内膜瘤的女性的体内观察提供了证据，表明子宫内膜瘤对卵母细胞的有害影响。再加上腹膜子宫内膜异位症手术破坏或切除或暂时药物抑制疾病和相关炎症后生育能力没有明显改善，现有证据使得子宫内膜异位症相关性不孕症在没有粘连引起的输卵管功能障碍的情况下值得怀疑.除了评估输卵管功能外，可能没有解剖分期与生育能力相关。在子宫内膜异位症患者中，辅助生殖技术与其他适应症一样有效。
