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Endometriosis and Infertility

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 3558

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Guest Editor
Department of Gynecology and Obstetrics, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
Interests: endometriosis; cancers
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Special Issue Information

Dear Colleagues,

Endometriosis is often associated with subfertility or infertility in women. The detailed mechanisms of this interrelationship have yet to be determined. The presence of endometriosis may cause infertility depending on the extent and characteristics of the disease. However, we still lack adequate markers to determine the relevance of endometriosis with regard to the cause, prognosis, and prediction of the effect of medical and non-medical treatment modalities. Major anatomical changes of the reproductive organs caused by endometriosis are regarded as potential mechanisms that interfere with various reproductive aspects, e.g., tubal infertility. The role of endometrioma as well deep endometriosis of the bowel in infertility has been debated for many years. It is still unclear in which cases surgery is required and, if so, which techniques should be applied. In addition to mechanistic aspects, the potential effect of endometriosis could be due to molecular alterations. Various factors such as immunological, endocrine, inflammatory, etc., have been demonstrated to be differentially regulated in women suffering from endometriosis, which may be relevant in reproduction. Although the commonly used endocrine therapies are often effective for pain relief in many women, these treatment modalities cannot be administered for fertility treatment, due to their contraceptive action. This is certainly one of the major unmet needs when treating endometriosis-associated infertility. Therefore, future research on the factors of endometriosis interfering with the physiological mechanisms of reproduction should advance the development of new agents as effective medical treatments in these women.

Prof. Dr. Ludwig Kiesel
Guest Editor

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Keywords

  • endometriosis
  • infertility
  • subfertility
  • physiological mechanisms
  • treatments

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Published Papers (2 papers)

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Review

12 pages, 435 KiB  
Review
The Role of miRNA in Endometriosis-Related Infertility—An Update
by Hanna Surmann and Ludwig Kiesel
Int. J. Mol. Sci. 2025, 26(12), 5862; https://doi.org/10.3390/ijms26125862 - 19 Jun 2025
Viewed by 314
Abstract
Endometriosis, affecting up to 10% of women in their reproductive years, is a chronic and multifactorial disease characterized by the presence of endometrial tissue outside the uterus. Traditionally associated with pain and infertility, recent studies highlight its systemic nature, implicating inflammatory, immunological, and [...] Read more.
Endometriosis, affecting up to 10% of women in their reproductive years, is a chronic and multifactorial disease characterized by the presence of endometrial tissue outside the uterus. Traditionally associated with pain and infertility, recent studies highlight its systemic nature, implicating inflammatory, immunological, and hormonal dysregulation in its pathogenesis. This paper explores the emerging role of microRNAs (miRNAs) in the pathophysiology of endometriosis and its related infertility. Evidence suggests that dysregulation of specific miRNAs influences cellular proliferation, migration, and progesterone resistance, thereby contributing to the development and progression of endometriotic lesions. Additionally, altered miRNA expression profiles hold promise as non-invasive biomarkers for improving diagnostic accuracy and as potential targets for novel therapeutic interventions. Although current diagnostic methods, such as laparoscopy, remain the gold standard, the integration of miRNA-based approaches could reduce reliance on invasive procedures and enhance treatment outcomes. Ultimately, further research—particularly regarding the interplay between endometriosis and infertility—is crucial to fully elucidate these complex mechanisms and foster the development of more effective diagnostic and therapeutic strategies. Full article
(This article belongs to the Special Issue Endometriosis and Infertility)
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22 pages, 1429 KiB  
Review
The Current Understanding of Molecular Mechanisms in Adenomyosis-Associated Infertility and the Treatment Strategy for Assisted Reproductive Technology
by Hsien-Ming Wu, Tian-Chi Tsai, Shang-Min Liu, Angel Hsin-Yu Pai and Liang-Hsuan Chen
Int. J. Mol. Sci. 2024, 25(16), 8937; https://doi.org/10.3390/ijms25168937 - 16 Aug 2024
Cited by 4 | Viewed by 2870
Abstract
Adenomyosis, endometriosis of the uterus, is associated with an increased likelihood of abnormal endometrial molecular expressions thought to impair implantation and early embryo development, resulting in disrupted fertility, including the local effects of sex steroid and pituitary hormones, immune responses, inflammatory factors, and [...] Read more.
Adenomyosis, endometriosis of the uterus, is associated with an increased likelihood of abnormal endometrial molecular expressions thought to impair implantation and early embryo development, resulting in disrupted fertility, including the local effects of sex steroid and pituitary hormones, immune responses, inflammatory factors, and neuroangiogenic mediators. In the recent literature, all of the proposed pathogenetic mechanisms of adenomyosis reduce endometrial receptivity and alter the adhesion molecule expression necessary for embryo implantation. The evidence so far has shown that adenomyosis causes lower pregnancy and live birth rates, higher miscarriage rates, as well as adverse obstetric and neonatal outcomes. Both pharmaceutical and surgical treatments for adenomyosis seem to have a positive impact on reproductive outcomes, leading to improved pregnancy and live birth rates. In addition, adenomyosis has negative impacts on reproductive outcomes in patients undergoing assisted reproductive technology. This association appears less significant after patients follow a long gonadotropin-releasing hormone agonist (GnRHa) protocol, which improves implantation rates. The pre-treatment of GnRHa can also be beneficial before engaging in natural conception attempts. This review aims to discover adenomyosis-associated infertility and to provide patient-specific treatment options. Full article
(This article belongs to the Special Issue Endometriosis and Infertility)
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