Endometriosis como causa de infertilidad. Revisión bibliográfica

Abstract

Background: Endometriosis remains a medical enigma that significantly impacts fertility in affected individuals. General Objective: The study aims to comprehensively analyze endometriosis as a leading cause of infertility through a scientific discussion. Methodology: A bibliographic review was conducted, encompassing studies with various research designs, including descriptive, cross-sectional, analytical, retrospective, randomized controlled trials, meta-analysis, and systematic reviews. These studies were published within five years and obtained from PubMed, Springer, Scopus, Web of Science, OVID, and Cochrane databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method was utilized, and articles were selected and structured within customized tables. Results: The mechanisms involved in endometriosis-related infertility include pain, an inflammatory response triggered by proinflammatory cytokines, functional ovarian tissue reduction due to endometriomas or surgery, and alterations in oocyte quality and quantity. Furthermore, new diagnostic tools, such as endometrial overexpression of BCL-6, microRNA and microbiota biomarkers in intestinal and peritoneal fluid, and autoantibodies against tropomyosin 3, α-enolase, and estradiol, have been discovered. The treatment should be personalized based on the clinical situation and the suspected degree of involvement. Current management options include surgery and assisted reproductive technologies. Conclusion: Endometriosis affects women of reproductive age, causing pain and infertility issues. The association between endometriosis and infertility is complex, controversial, and multifactorial but supported by various studies. Developing innovative and non-invasive diagnostic tools is currently a primary clinical and research priority, as delay in diagnosis is detrimental to women who wish to conceive.