How Endometriosis Affects Embryo Implantation

Endometriosis is a complex condition defined by the presence of endometrial tissue outside of the uterus. This condition causes inflammation and severe pelvic pain, particularly during a woman’s menstrual cycle. In severe cases, endometriosis can hinder embryo implantation, resulting in IVF failure. Here is how endometriosis affects fertility and implantation for patients undergoing IVF:

The Impact of Endometriosis on Fertility

The ovaries, fallopian tubes, and pelvic lining may develop endometrial growths, which can disrupt fertility. While women with endometriosis have lower chances of conception, IVF treatment increases their chances of having a baby. Before beginning IVF, a fertility doctor tests for endometriosis markers to determine the risk of IVF failure. These are some of the factors in women with endometriosis that may affect embryo implantation:

Structural Changes to Reproductive Organs

Endometriosis can cause inflammation, adhesions, and scarring on the walls of the uterus, which may distort its structure. Due to these changes, the fertilized egg may struggle to attach to the uterine walls. Structural changes to other reproductive organs interfere with the embryo’s journey to the uterus, reducing the chances of it reaching the endometrial lining for implantation.

Changes to Endometrial Receptivity

For successful implantation, the uterine lining must reach a state of receptivity where it is primed for embryo implantation. Progesterone influences the endometrium’s receptivity to implantation, as it is responsible for thickening the uterine lining in preparation for implantation. Hormonal imbalances due to endometriosis cause estrogen dominance. High estrogen levels cause a decline in the expression of progesterone receptors in the endometrium, reducing its sensitivity to progesterone. As a result, the uterine lining does not thicken enough, which impedes the embryo’s ability to implant.

Endometriosis also affects the endometrium’s adhesive capacity, preventing the embryo from securely attaching to the uterine lining. Integrins are the cell adhesion molecules in the uterus affected by endometriosis. Women with endometriosis may have reduced or absent integrins. This makes the uterus inhospitable for the embryo, resulting in a failed IVF cycle.

Embryo Quality Issues

Endometriosis causes scar tissue to form, which can alter the regular supply of blood, nutrients, and oxygen to the ovaries, hindering egg maturation. When endometriosis goes untreated, it causes inflammation, which may release cytokines and macrophages, which are toxic inflammatory substances. These harmful inflammatory substances affect the ovarian reserve by lowering egg quality. Because of the low quality of the ova, natural fertilization and implantation may become impossible. An IVF specialist prescribes medications to improve egg development, and they examine the collected eggs to determine they are good quality. The specialist then preserves the healthy ova and prepares them for fertilization and transfer into the uterus.

Managing Endometriosis-Related Implantation Challenges

Because of the many ways endometriosis affects implantation, fertility doctors conduct a biopsy of endometrial tissue after implantation failure during IVF. If the biopsy reveals endometriosis markers, the doctor determines the extent of the condition to choose the best treatment method. If there are large scars or adhesions on the uterine wall, a fertility doctor may conduct laparoscopic surgery to remove the excessive endometriotic tissue. Hormonal treatments to regulate estrogen and progesterone levels may help restore endometrial receptivity. If a woman has poor egg quality due to endometriosis, her fertility doctor may recommend IVF with a donor egg.

Improve Implantation Chances After IVF Failure

Endometriosis causes issues like inflammation, hormonal imbalances, and uterine scarring, which increases the risk of IVF failure. If a woman has recurrent IVF failure, endometriosis testing helps identify and address potential causes of implantation failure. Screening for endometriosis gene biomarkers like BCL6 indicates endometriosis-related inflammation. Contact a fertility specialist today to schedule a diagnostic test and learn more about endometriosis and IVF.