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Endometriosis, recurrent miscarriage and implantation failure: is there an immunological link?
Abstract
Endometriosis is more frequently diagnosed in patients with infertility than in a normal population. The goal of this paper is to give an overview of the clinical and fundamental evidence for a possible link between endometriosis and (recurrent) miscarriage or implantation failure after treatment with assisted reproductive technology. According to the literature, there is insufficient evidence for an association between endometriosis and (recurrent) miscarriage, but there is, however, epidemiological evidence to support the link between endometriosis and recurrent implantation failure after assisted reproduction. This can possibly be explained by alterations in humoral and cell-mediated immunity in women with endometriosis. Humoral immunological changes include increased formation of antibodies against endometrial antigens, anti-laminin-1 auto-antibodies and other auto-immune antibodies (e.g. antiphospholipid). Cell-mediated immunological changes include alterations in peritoneal and follicular fluid immune cells and cytokines. The possible negative effect of these immunological changes on folliculogenesis, ovulation, oocyte quality, early embryonic development and implantation in women with endometriosis suggests that infertility in endometriosis patients may be related to alterations within the follicle or oocyte, resulting in embryos with decreased ability to implant.
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“Retrospective studies have suggested that women with endometriosis may have higher rates of maternal complications and fetal problems such as preeclampsia and miscarriage (46–50), though these associations need further study.”
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Metadata
- Authors
- Tomassetti, C., Meuleman, C., Pexsters, A., Mihalyi, A., Kyama, C., Simsa, P., & D'Hooghe, T.
- Affiliations
- Universitair Ziekenhuis Leuven (BE)
- Venue
- Reproductive BioMedicine Online
- Publisher
- Elsevier BV
- Published
- 2006-01
- Volume
- 13
- Issue
- 1
- Pages
- 58-64
- ISSN
- 1472-6483 (ISSN-L)
- OpenAlex
- W2085072288
- Cited by
- 106
- References
- 67
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 5 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 2 · 2014: 7 · 2013: 8 · 2012: 6
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive BioMedicine Online (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
- Keywords
- endometriosis, recurrent pregnancy loss, implantation failure, assisted reproduction, autoantibodies, antiphospholipid antibodies, cell-mediated immunity, humoral immunity, follicular fluid, peritoneal fluid, cytokines, oocyte quality, folliculogenesis, ovulation, infertility
- MeSH terms
- Abortion, Habitual, Autoantibodies, Endometriosis, Endometrium, Female, Fertilization in Vitro, Humans, Immunity, Cellular, Infertility, Female, Embryo Implantation, Pregnancy, Gene Expression, Cytokines, Treatment Failure, Reproductive Techniques, Assisted, Embryonic Development
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