In Vivo Shadows and In Vitro Light: The Early Embryological Journey Amid Endometriosis.

Area of Science:

• Reproductive Endocrinology
• Immunology
• Genetics

Background:

• Endometriosis presents complex challenges to female fertility, involving chronic inflammation, oxidative stress, and anatomical distortions.
• These factors adversely affect oocyte quality, embryo development, and successful implantation, complicating natural conception.
• In vitro fertilization (IVF) provides a controlled setting to mitigate some in vivo fertility barriers associated with endometriosis.

Purpose of the Study:

• To systematically review the impact of endometriosis on oocyte dysfunction and IVF outcomes.
• To evaluate current and emerging strategies for improving fertility in endometriosis patients undergoing assisted reproductive technologies.
• To identify gaps in personalized prognosis and targeted therapeutic approaches for endometriosis-related infertility.

Main Methods:

• Systematic literature review focusing on endometriosis, oocyte quality, embryo development, implantation, and IVF outcomes.
• Analysis of evidence regarding the mechanisms of endometriosis-associated infertility, including inflammatory and oxidative pathways.
• Exploration of innovative technologies such as AI-driven embryo selection, single-cell omics, and immunomodulation.

Main Results:

• Endometriosis is linked to impaired oocyte quality and reduced embryo development, contributing to lower IVF success rates.
• IVF outcomes in endometriosis patients are variable, influenced by disease severity and specific treatment protocols.
• Emerging technologies like AI embryo selection and immunomodulatory therapies show potential for enhancing IVF success.

Conclusions:

• Despite advancements, personalized prognosis and targeted therapies for endometriosis-related infertility require further development.
• Innovative tools such as AI, single-cell omics, and immunomodulation offer promising avenues for improving fertility outcomes.
• A patient-centered approach integrating scientific evidence with personalized care is crucial for managing endometriosis and infertility.