Endometriosis, Infertility, and Oocyte Quality

  • Andrea Tinelli
  • Ceana H. Nezhat
  • Farr R. Nezhat
  • Ospan A. Mynbaev
  • Radmila Sparic
  • Ioannis P. Kosmas
  • Renata Beck
  • Antonio Malvasi


Endometriosis is a gynecological disease characterized by the presence of endometrial glandular and stromal cells existing in the extra-uterine environment. Estimates show that endometriosis affects 10–15% of all women of reproductive age. Approximately, 25–50% of infertile women may be affected by endometriosis and 30–50% patients with endometriosis may suffer from infertility. Several mechanisms have been proposed for the association of endometriosis and infertility, including distorted pelvic anatomy, impaired ovary function, altered microenvironment, affected endometrial receptivity, and reduced oocyte/embryo quality. Patients with endometriosis have inflammatory processes within the increased amount of peritoneal fluid noted. These inflammatory processes and hormonal changes have shown to alter folliculogenesis, sperm motility, tubal transport, and embryo implantation.

Oocyte quality is an important factor in the success of assisted reproductive technology treatment, and the environment of follicle growth has a significant influence on this quality. It is very difficult, however, to directly evaluate oocyte quality. Follicular fluid (FF), however, might reflect the environment during follicle and oocyte growth. Therefore, an evaluation of oxidative stress in the FF might be useful in predicting oocyte quality.


Endometriosis Ovarian pick up Laparoscopy Reproduction Sterility Pregnancy Inflammation 



Assisted reproductive technique


Controlled ovarian hyperstimulation


Controlled ovarian stimulation


Cyclooxygenase-2 prostaglandin-2


Follicular fluid


Granulocyte macrophage-colony stimulator factor


Glutathione peroxidase


Glutathione reductase


Intracytoplasmatic sperm injection
















In vitro fertilization


Lipid peroxidation


Monocyte chemotactic protein-1


Mast cells


Matrix metalloproteinases


Natural Killer


Nitric oxide


Ovarian follicular fluid


Oxidative stress


Polymerase chain reaction


Platelet-derived growth factor


Peritoneal fluid




Peripheral plasma




Reactive oxygen species


Superoxide dismutase


Superoxide dismutase 1


Total antioxidant capacity


Transmission electron microscopy


Transforming growth factor-β


Tumor necrosis factor-α


Vascular endothelial growth factor 3


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andrea Tinelli
    • 1
    • 2
  • Ceana H. Nezhat
    • 3
    • 4
    • 5
    • 6
  • Farr R. Nezhat
    • 7
    • 8
  • Ospan A. Mynbaev
    • 2
    • 9
    • 10
  • Radmila Sparic
    • 11
    • 12
  • Ioannis P. Kosmas
    • 2
    • 13
  • Renata Beck
    • 2
    • 13
  • Antonio Malvasi
    • 2
    • 14
  1. 1.Division of Experimental Endoscopic Surgery, Imaging, Technology and Minimally Invasive Therapy, Department of Obstetrics and GynecologyVito Fazzi HospitalLecceItaly
  2. 2.Laboratory of Human Physiology, Phystech BioMed School, Faculty of Biological and Medical PhysicsMoscow Institute of Physics and Technology (State University)DolgoprudnyRussia
  3. 3.Minimally Invasive Surgery Fellowship ProgramNezhat Medical CenterAtlantaUSA
  4. 4.Training and Education Program, and Minimally Invasive Surgery and RoboticsNorthside HospitalAtlantaUSA
  5. 5.Department of Gynecology and ObstetricsSchool of Medicine, Emory UniversityAtlantaUSA
  6. 6.Society of Reproductive SurgeonsBirminghamUSA
  7. 7.Department of Obstetrics and GynecologyWeill Cornell Medical College of Cornell UniversityNewYorkUSA
  8. 8.Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and GynecologyNYU-Winthrop University Hospital, State University of New York at Stony Brook, College of MedicineNewYorkUSA
  9. 9.Division of Molecular TechnologiesResearch Institute of Translational Medicine, N. I. Pirogov Russian National Research Medical UniversityMoscowRussia
  10. 10.Institute of Numerical Mathematics, RASMoscowRussia
  11. 11.Clinic of Gynecology and ObstetricsClinical Center of SerbiaBelgradeSerbia
  12. 12.School of Medicine, University of BelgradeBelgradeSerbia
  13. 13.Department of Obstetrics and GynecologyIoannina State General Hospital G. HatzikostaIoanninaGreece
  14. 14.Department of Obstetrics and GynecologyGVM Care and Research Santa Maria HospitalBariItaly

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