OVARIAN DYSFUNCTION IN ENDOMETRIOSIS-ASSOCIATED AND UNEXPLAINED INFERTILITY

Purpose: The impact of endometriosis and unexplained infertility on fo llicular function and fertilization of oocytes in cycles totally unper turbed by exogenous gonadotrophins, when compared with controls with t ubal damage, were examined. Methods: In natural cycles, without any ex ogenous gonadotropins, endocrine and ultrasonographic studies of folli cular maturation in 18 women with minor endometriosis (41 cycles), 15 women with unexplained infertility (31 cycles), and 34 women with tuba l damage (88 cycles) were performed. Results: The endometriosis group had a significantly longer follicular phase (median: 15, 13, and 13 da ys). Both endometriosis and unexplained infertility had significantly reduced LH concentrations in follicular fluid compared with tubal dama ge (median: 12.1, 11.5, and 15.9 IU/L, respectively). Endometriosis wa s associated with a significantly reduced fertilization rate compared with unexplained infertility or tubal damage (46, 65, and 69%, respect ively). Conclusions: These data show continuing evidence of ovulatory dysfunction leading to reduced fertilization rates in women with minor endometriosis.