Endometriosis is a chronic gynecologic disease process with multifactorial etiology. Increased oxidative stress, a result of increased production of free radicals or depletion of the body’s endogenous antioxidant defense, has been implicated in its pathogenesis. Oxidative stress is thought to promote angiogenesis and the growth and proliferation of endometriotic implants. Oxidative stress in the reproductive [...]

Endometriosis is a chronic gynecologic disease process with multifactorial etiology. Increased oxidative stress, a result of increased production of free radicals or depletion of the body’s endogenous antioxidant defense, has been implicated in its pathogenesis. Oxidative stress is thought to promote angiogenesis and the growth and proliferation of endometriotic implants. Oxidative stress in the reproductive tract microenvironment is known to negatively affect sperm count and quality and may also arrest fertilized egg division leading to embryo death. Increased DNA damage in sperm, oocytes, and resultant embryos may account for the increase in miscarriages and fertilization and implantation failures seen in patients with endometriosis.

The evidence linking endometriosis and infertility to endogenous pro-oxidant imbalance provides a rationale for the empiric use of antioxidant therapy. Vitamin C and E deficiency has been demonstrated in women with endometriosis. Observational and randomized controlled studies have shown vitamin C and E combination therapy to decrease markers of oxidative stress.

SOURCE: Studies on Women’s Health

Endometriosis is a chronic gynecologic disease process with multifactorial etiology. Increased oxidative stress, a result of increased production of free radicals or depletion of the body’s endogenous antioxidant defense, has been implicated in its pathogenesis. Oxidative stress is thought to promote angiogenesis and the growth and proliferation of endometriotic implants. Oxidative stress in the reproductive tract microenvironment is known to negatively affect sperm count and quality and may also arrest fertilized egg division leading to embryo death. Increased DNA damage in sperm, oocytes, and resultant embryos may account for the increase in miscarriages and fertilization and implantation failures seen in patients with endometriosis.

The evidence linking endometriosis and infertility to endogenous pro-oxidant imbalance provides a rationale for the empiric use of antioxidant therapy. Vitamin C and E deficiency has been demonstrated in women with endometriosis. Observational and randomized controlled studies have shown vitamin C and E combination therapy to decrease markers of oxidative stress.

…We know also that inflammation is a very important part of endometriosis and whether the inflammation causes endometriosis or whether endometriosis causes inflammation, and I think it is both, but this all plays a part in why patients end up in our practice with infertility. The majority of these patients as I said have not a single painful symptom of endometriosis. In fact, one of the first symptoms that we see is infertility and recurrent pregnancy loss and pregnancy complications.

…What we found in these situations are that young women with low ovarian reserve typically have one of three reasons; it is familial, it is genetic and we see that. The mother went into menopause early, they may do that, it is genetic. The second is it is autoimmune that there is an autoimmune attack against the follicles called autoimmune oophoritis and we can easily identify that. But number three is almost always endometriosis. It is an inflammatory environment in the pelvis and we all know these peritoneal fluids are saturated with inflammatory cytokines. We know that the follicles that are generated during IVF when they look inside the follicular fluid they have very high levels of prodigal reactive oxygen species, a by-product of oxidative stress, a by-product of all these elevated cytokines in the pelvis, and we know this affects eggs.

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