Some of endometriosis infertility caused by tubal patency, there is no pelvic anatomical abnormalities in the structure of their infertility for the following reasons:
1. Ascites volume, composition and infertility. Of ascites in patients with volume 10-20ml, while the normal <10ml. Ascites in patients with macrophages and lymphocytes increase in ascites acid phosphatase increased, this macrophage function in the activation phenomenon, activated macrophages can swallow Sperm pregnancy. In addition, macrophages and antigen substances, such as inflammatory material with the back of the blood encounter, it will speed up the breeding division of the sperm and egg cells have a direct toxic effect, thereby interfering with pregnancy.
2. Endometriosis may be associated with non-ovulation. It is reported that endometriosis, 17% -27% did not ovulate, its mechanisms and LH receptor in patients with follicular cells less relevant.
3. Ovarian luteal phase defect. Was observed that some patients with luteal phase ≤ 10 days and regular pathological examination of endometrial luteal phase defect, its incidence of luteal defects reported 25% -40%. Luteal phase defect not only reduce the pregnancy rate, while increasing the rate of spontaneous abortion.
4. Luteinized follicle did not rupture syndrome (LUF). Ji Zhi follicle luteinized without ovulation, and luteinizing and follicle stimulating the formation of corpus luteum, but the mature egg is not broken out the corpus luteum and into the abdominal cavity. Although the increase in the concentration of serum progesterone, basal body temperature two-phase, the endometrium was secretory phase change, but laparoscopic ovarian corpus luteum after ovulation did not see the broken hole. Ascites in progesterone levels were significantly lower than the normal. It is reported that endometriosis in the, LUF the incidence could be as high as 75%, and the detection of ascites within the proposed progesterone content was the best way to diagnose this syndrome.
5. Ascites interleukin Ⅰ and Ⅱ increased and infertility. Interleukin-Ⅰ is a kind of macrophage cells to produce specific proteins, can induce T cell differentiation, proliferation, and produce interleukin-Ⅱ, can stimulate the synthesis of prostaglandins, so that increase in fiber cells, activation and cellular function of immune globulin . Patients with ascites presence of ectopic IL-Ⅰ and IL-Ⅱ, and with the disease can increase.
6. Ascites of prostaglandin (PGF2a) increased secretion and infertility. The study found ascites in patients with prostaglandin concentrations higher than normal. The increased prostaglandin can affect the mature follicles and cause luteal phase defect. In addition, the ascites of prostaglandins increases, can tubal cramps, rhythmic movement disorder and to make Yunluan Development and decidual changes are not synchronized, and thus affect the Yunluan, and implantation.
7. High prolactin hyperlipidemia. According to a group of 14 reported cases of uterine endometriosis, and 7 patients had breast milk, and 3 cases of increased PRL. Description of infertility endometriosis is often associated with lactation and PRL increased, thereby affecting ovarian function, resulting in no ovulation.
8. Autoimmunity and infertility. Some pairs of endometriosis in serum, cervical secretion antibody was found in patients with serum anti-endometrial and anti-ovarian antibody titers were significantly higher, cervical secretions of the anti-ovarian antibody titers increased. At the same time, the patient serum and ascites of C3 and C4 complement higher than normal, complement increased mean that the presence of inflammation. This attracted the participation of complement against ectopic endometrial inflammation, is a self-immune response. Anti-ovary antibody rise can affect ovulation and luteal dysfunction, anti-endometrial antibody rise can affect a change to the detriment of endometrial implantation Yunluan.
Thus, infertility in endometriosis due to the formation of a variety of factors.