Can Endometriosis Cause Infertility?
Yes, but mechanisms of infertility associated with endometriosis are uncertain. The impact on fertility of endometriosis likely depends on the severity or stage of the disease as defined by the American Society of Reproductive Medicine staging system.
Although Stage I (minimal) or II (mild) endometriosis may be identified during infertility evaluation, it is uncertain if early-stage disease is the cause of infertility in these women. It is hypothesized that minimal/mild endometriosis is associated with an inflammatory response that impairs ovarian, peritoneal, tubal, and endometrial function.
Advanced endometriosis (Stage III or IV disease) is associated with distorted pelvic anatomy and adhesions. These changes can impair oocyte release or pick-up, alter sperm motility, cause disordered myometrial contractions, and impair fertilization and embryo transport.