Advancements to treat various types of Male and Female Infertility
DOI:
https://doi.org/10.63682/jns.v14i32S.8302Keywords:
Endometriosis, infertility, estrogen-dependence, oxidative stress, IVF, HIFU, nanotechnology, MCP-1, IL-6, ART, ethical issues, reproductive healthAbstract
Male infertility is a growing concern that affects approximately 15% of couples worldwide, with male factors contributing to nearly half of these cases. Recent studies have highlighted a significant relationship between obesity and male reproductive health, suggesting that excess body weight may negatively impact fertility through various biological mechanisms. Obesity is characterized by an increased accumulation of adipose tissue, which alters hormonal balance, particularly affecting testosterone levels and leading to metabolic dysfunction. Research indicates that obesity can lead to a state of chronic inflammation and oxidative stress, which can impair spermatogenesis and reduce sperm quality. Additionally, elevated body mass index (BMI) has been associated with lower sperm concentration, motility, and morphology. The mechanism behind these effects may include hormonal alternations, such as increased estrogen levels due to aromatization of testosterone in adipose tissue, as well as the detrimental impact of obesity –related comorbidities, including insulin resistance and diabetes. Endometriosis is a common estrogen-related disease in women of reproductive age, usually associated with chronic pelvic pain, infertility, and psychological distress, i.e., anxiety and depression. The condition is defined by the presence of endometrial glands and stroma implanted outside the uterine cavity, most typically found in the uterus, fallopian tubes, and ovaries. Pathophysiological processes include endocrine disturbances, immune derangement, and oxidative stress. Endometrial cells also secrete cytokines like MCP-1 and IL-6, which interfere with normal follicular development and luteal function. Sterility occurs in 30–50% of patients with endometriosis, creating management dilemmas and causing decreased quality of life. Diagnosis is largely dependent on non-invasive imaging studies, while therapy encompasses hormonal treatment, lifestyle changes, and ART like IVF. Surgical procedures have limited efficacy for established cases, and recurrence is frequent. New strategies such as high-intensity focused ultrasound (HIFU) and nanotechnology-based therapies hold great promise by treating lesions noninvasively and combating oxidative stress. Ethical dimensions of the treatment of endometriosis involve respecting patient autonomy, informed consent, and fair access to treatments. A multidisciplinary patient-centered model is necessary to maximize outcomes in endometriosis-associated infertility.
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References
Jenkins, S., Olive, D. L., & Haney, A. F. (1986). Endometriosis: pathogenetic implications of anatomic distribution. Obstetrics and gynecology, 67(3), 335–338.
Tsamantioti ES, Mahdy H. Endometriosis. [Updated 2023 Jan 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.
https://www.who.int/news-room/fact-sheets/detail/infertility
Bulletti, C., Coccia, M. E., Battistoni, S., & Borini, A. (2010). Endometriosis and infertility. Journal of assisted reproduction and genetics, 27(8), 441–447. https://doi.org/10.1007/s10815-010-9436-1
Bonavina, G., & Taylor, H. S. (2022). Endometriosis-associated infertility: From pathophysiology to tailored treatment. Frontiers in endocrinology, 13, 1020827. https://doi.org/10.3389/fendo.2022.1020827
Surrey E. S. (2015). Endometriosis-Related Infertility: The Role of Assisted Reproductive Technologies. BioMed research international, 2015, 482959. https://doi.org/10.1155/2015/482959
Kheil, M. H., Sharara, F. I., Ayoubi, J. M., Rahman, S., & Moawad, G. (2022). Endometrioma and assisted reproductive technology: a review. Journal of assisted reproduction and genetics, 39(2), 283–290. https://doi.org/10.1007/s10815-022-02403-5
Qiong Chen, Jing Wang, Xiaoya Ding, Qingfei Zhang, Ping Duan, Emerging strategies for the treatment of endometriosis, Biomedical Technology, Volume 7, 2024, Pages 46-62, ISSN 2949-723X, https://doi.org/10.1016/j.bmt.2024.08.002.
Kong, X., Chen, H., Li, F., Zhang, F., Jiang, Y., Song, J., ... & Shi, J. (2023). Three-dimension chitosan hydrogel loading melanin composite nanoparticles for wound healing by anti-bacteria, immune activation and macrophage autophagy promotion. International Journal of Biological Macromolecules, 237, 124176.
Bala, V. M., Lampropoulou, D. I., Grammatikaki, S., Kouloulias, V., Lagopati, N., Aravantinos, G., & Gazouli, M. (2023). Nanoparticle-mediated hyperthermia and cytotoxicity mechanisms in cancer. International journal of molecular sciences, 25(1), 296.
Gong, Y., Hu, X., Chen, M., & Wang, J. (2024). Recent progress of iron-based nanomaterials in gene delivery and tumor gene therapy. Journal of Nanobiotechnology, 22(1), 309.
Zou, G., Wang, J., Xu, X., Xu, P., Zhu, L., Yu, Q., ... & Zhang, X. (2021). Cell subtypes and immune dysfunction in peritoneal fluid of endometriosis revealed by single-cell RNA-sequencing. Cell & Bioscience, 11(1), 98.
Bakinowska, E., Kiełbowski, K., Boboryko, D., Bratborska, A. W., Olejnik-Wojciechowska, J., Rusiński, M., & Pawlik, A. (2024). The role of stem cells in the treatment of cardiovascular diseases. International journal of molecular sciences, 25(7), 3901.
Tanbo, T., & Fedorcsak, P. (2017). Endometriosis‐associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta obstetricia et gynecologica Scandinavica, 96(6), 659-667.
Practice Committee of the American Society for Reproductive Medicine. (2012). Endometriosis and infertility: a committee opinion. Fertility and sterility, 98(3), 591-598.
Macer, M. L., & Taylor, H. S. (2012). Endometriosis and infertility: a review of the pathogenesis and treatment of endometriosis-associated infertility. Obstetrics and Gynecology Clinics, 39(4), 535-549.
Havers-Borgersen, E., Hartwell, D., Ekelund, C., Butt, J. H., Østergaard, L., Holgersson, C., ... & Fosbøl, E. L. (2024). Endometriosis and long-term cardiovascular risk: a nationwide Danish study. European heart journal, 45(44), 4734-4743.
Koller, D., Pathak, G. A., Wendt, F. R., Tylee, D. S., Levey, D. F., Overstreet, C., ... & Polimanti, R. (2023). Epidemiologic and genetic associations of endometriosis with depression, anxiety, and eating disorders. JAMA network open, 6(1), e2251214-e2251214.
Vercellini, P., Viganò, P., Bandini, V., Buggio, L., Berlanda, N., & Somigliana, E. (2023). Association of endometriosis and adenomyosis with pregnancy and infertility. Fertility and sterility, 119(5), 727-740.
Qi, Q., Li, Y., Chen, Z., Luo, Z., Zhou, T., Zhou, J., ... & Wang, L. (2025). Update on the pathogenesis of endometriosis-related infertility based on contemporary evidence. Frontiers in Endocrinology, 16, 1558271.
Erin Brown, Rocío Martínez-Aguilar, Jacqueline A. Maybin, Douglas A. Gibson, Chapter Six – Endometrial macrophages in health and disease, Editor(s): Samanta A. Mariani, Luca Cassetta, Lorenzo Galluzzi, International Review of Cell and Molecular Biology, Academic Press, Volume 367, 2022, Pages 183-208, ISSN 1937-6448, ISBN 9780323907415, https://doi.org/10.1016/bs.ircmb.2022.03.011.
Vannuccini, S., Clemenza, S., Rossi, M., & Petraglia, F. (2022). Hormonal treatments for endometriosis: The endocrine background. Reviews in Endocrine and Metabolic Disorders, 23(3), 333-355.
Kumar, T. R. (2023). Rerouting of follicle-stimulating hormone secretion and gonadal function. Fertility and sterility, 119(2), 180-183.
Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021). Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. The Lancet, 397(10276), 839-852.
Bulun, S. E., Monsavais, D., Pavone, M. E., Dyson, M., Xue, Q., Attar, E., ... & Su, E. J. (2012, January). Role of estrogen receptor-β in endometriosis. In Seminars on Reproductive Medicine (Vol. 30, No. 01, pp. 39-45). Thieme Medical Publishers.
Reis, F. M., Coutinho, L. M., Vannuccini, S., Batteux, F., Chapron, C., & Petraglia, F. (2020). Progesterone receptor ligands for the treatment of endometriosis: the mechanisms behind therapeutic success and failure. Human Reproduction Update, 26(4), 565-585.
Ding, Y., Zhu, Q., He, Y., Lu, Y., Wang, Y., Qi, J., ... & Sun, Y. (2021). Induction of autophagy by Beclin-1 in granulosa cells contributes to follicular progesterone elevation in ovarian endometriosis. Translational Research, 227, 15-29.
Mokhtari, T., Irandoost, E., & Sheikhbahaei, F. (2024). Stress, pain, anxiety, and depression in endometriosis–Targeting glial activation and inflammation. International Immunopharmacology, 132, 111942.
Giudice, M. G., De Michele, F., Poels, J., Vermeulen, M., & Wyns, C. (2017). Update on fertility restoration from prepubertal spermatogonial stem cells: how far are we from clinical practice? Stem cell research, 21, 171-177.
Koller, D., Pathak, G. A., Wendt, F. R., Tylee, D. S., Levey, D. F., Overstreet, C., ... & Polimanti, R. (2023). Epidemiologic and genetic associations of endometriosis with depression, anxiety, and eating disorders. JAMA network open, 6(1), e2251214-e2251214.
Marečková, M., Garcia-Alonso, L., Moullet, M., Lorenzi, V., Petryszak, R., Sancho-Serra, C., ... & Vento-Tormo, R. (2024). An integrated single-cell reference atlas of the human endometrium. Nature Genetics, 56(9), 1925-1937.
Kim, H. G., Lim, Y. S., Hwang, S., Kim, H. Y., Moon, Y., Song, Y. J., ... & Yoon, S. (2022). Di-(2-ethylhexyl) phthalate triggers proliferation, Migration, Stemness, and epithelial–mesenchymal transition in human endometrial and endometriotic epithelial cells via the transforming growth Factor-β/Smad signaling pathway. International Journal of Molecular Sciences, 23(7), 3938.
Sandoval, P., Jiménez‐Heffernan, J. A., Guerra‐Azcona, G., Pérez‐Lozano, M. L., Rynne‐Vidal, Á., Albar‐Vizcaíno, P., ... & López‐Cabrera, M. (2016). Mesothelial‐to‐mesenchymal transition in the pathogenesis of post‐surgical peritoneal adhesions. The Journal of Pathology, 239(1), 48-59.
Kabil, S. L., Rashed, H. E., Mohamed, N. M., & Elwany, N. E. (2023). Parthenolide repressed endometriosis induced surgically in rats: Role of PTEN/PI3Kinase/AKT/GSK-3β/β-catenin signaling in inhibition of epithelial mesenchymal transition. Life sciences, 331, 122037.
Cao, X., Yang, D., Song, M., Murphy, A., & Parthasarathy, S. (2004). The presence of endometrial cells in the peritoneal cavity enhances monocyte recruitment and induces inflammatory cytokines in mice: implications for endometriosis. Fertility and sterility, 82, 999-1007.
Bouet, P. E., Chao de la Barca, J. M., Boucret, L., Descamps, P., Legendre, G., Hachem, H. E., ... & May-Panloup, P. (2020). Elevated levels of monocyte chemotactic protein-1 in the follicular fluid reveals different populations among women with severe endometriosis. Journal of Clinical Medicine, 9(5), 1306.
Bordon, Y. (2023). CXCL8 blockade reduces fibrosis in endometriosis. Nature Reviews Immunology, 23(4), 203-203.
Jørgensen, H., Fedorcsak, P., Isaacson, K., Tevonian, E., Xiao, A., Beste, M., ... & Griffith, L. (2022). Endometrial cytokines in patients with and without endometriosis are evaluated for infertility. Fertility and sterility, 117(3), 629-640.
Huang, X., Wu, L., Pei, T., Liu, D., Liu, C., Luo, B., ... & Huang, W. (2023). Single-cell transcriptome analysis reveals endometrial immune microenvironment in minimal/mild endometriosis. Clinical and experimental immunology, 212(3), 285-295.
Da Luz, C. M., Da Broi, M. G., Placa, J. R., Silva Jr, W. A., Meola, J., & Navarro, P. A. (2021). Altered transcriptome in cumulus cells of infertile women with advanced endometriosis with and without endometrioma. Reproductive BioMedicine Online, 42(5), 952-962.
Santanam, N., Zoneraich, N., & Parthasarathy, S. (2017). Myeloperoxidase as a potential target in women with endometriosis undergoing IVF. Reproductive Sciences, 24(4), 619-626.
Cacciottola, L., Donnez, J., & Dolmans, M. M. (2021). Oxidative stress, mitochondria, and infertility: Is the relationship fully established? Fertility and Sterility, 116(2), 306-308.
Wu, Y., Yang, R., Lan, J., Wu, Y., Huang, J., Fan, Q., ... & Zhang, Q. (2023). Iron overload modulates follicular microenvironment via ROS/HIF-1α/FSHR signaling. Free Radical Biology and Medicine, 196, 37-52.
Ni, Z., Li, Y., Song, D., Ding, J., Mei, S., Sun, S., ... & Yu, C. (2022). Iron-overloaded follicular fluid increases the risk of endometriosis-related infertility by triggering granulosa cell ferroptosis and oocyte dysmaturity. Cell death & disease, 13(7), 579.
Chen, X., Zhou, Y., Wu, D., Shu, C., Wu, R., Li, S., ... & Shu, J. (2021). Iron overload compromises preimplantation mouse embryo development. Reproductive Toxicology, 105, 156-165.
Li, S., Zhou, Y., Huang, Q., Fu, X., Zhang, L., Gao, F., ... & Shu, J. (2021). Iron overload in endometriosis peritoneal fluid induces early embryo ferroptosis mediated by HMOX1. Cell death discovery, 7(1), 355.
Imanaka, S., Yamada, Y., Kawahara, N., & Kobayashi, H. (2021). A delicate redox balance between iron and heme oxygenase-1 is an essential biological feature of endometriosis. Archives of Medical Research, 52(6), 641-647.
Hudelist, G., Fritzer, N., Thomas, A., Niehues, C., Oppelt, P., Haas, D., ... & Salzer, H. (2012). Diagnostic delay for endometriosis in Austria and Germany causes and possible consequences. Human reproduction, 27(12), 3412-3416.
Wahl, K. J., Yong, P. J., Bridge-Cook, P., Allaire, C., & Canada, E. (2021). Endometriosis in Canada: it is time for collaboration to advance patient-oriented, evidence-based policy, care, and research. Journal of obstetrics and gynaecology Canada, 43(1), 88-90.
Vilasagar, S., Bougie, O., & Singh, S. S. (2020). A practical guide to the clinical evaluation of endometriosis-associated pelvic pain. Journal of minimally invasive gynecology, 27(2), 270-279.
Becker, C. M., Bokor, A., Heikinheimo, O., Horne, A., Jansen, F., Kiesel, L., ... & Vermeulen, N. (2022). ESHRE guideline: endometriosis. Human reproduction open, 2022(2), hoac009.
Roman, H. (2018). Endometriosis surgery and preservation of fertility, what surgeons should know. Journal of Visceral Surgery, 155, S31-S36.
Benaglia, L., Somigliana, E., Vercellini, P., Abbiati, A., Ragni, G., & Fedele, L. (2009). Endometriotic ovarian cysts negatively affect the rate of spontaneous ovulation. Human Reproduction, 24(9), 2183-2186.
Horikawa, T., Nakagawa, K., Ohgi, S., Kojima, R., Nakashima, A., Ito, M., ... & Saito, H. (2008). The frequency of ovulation from the affected ovary decreases following laparoscopic cystectomy in infertile women with unilateral endometrioma during a natural cycle. Journal of assisted reproduction and genetics, 25, 239-244.
Jayaprakasan, K., Becker, C., & Mittal, M. (2018). The effect of surgery for endometriomas on fertility: scientific impact paper no. 55. BJOG-AN International Journal of Obstetrics and Gynaecology, 125(6), E19-E28.
Ahmad, G., Phillips, K., & Watson, A. (2019). Laparoscopic entry techniques. Cochrane database of systematic reviews, (1).
Donnez, J., Nisolle, M., Gillet, N., Smets, M., Bassil, S., & Casanas-Roux, F. (1996). Large ovarian endometriomas. Human reproduction, 11(3), 641-645.
Brosens, I. A., Van Ballaer, P., Puttemans, P., & Deprest, J. (1996). Reconstruction of the ovary containing large endometriomas by an extraovarian endosurgical technique. Fertility and sterility, 66(4), 517-521.
Muzii, L., Bellati, F., Bianchi, A., Palaia, I., Manci, N., Zullo, M. A., ... & Panici, P. B. (2005). Laparoscopic stripping of endometriomas: a randomized trial on different surgical techniques. Part II: pathological results. Human Reproduction, 20(7), 1987-1992.
Chang, H. J., Han, S. H., Lee, J. R., Jee, B. C., Lee, B. I., Suh, C. S., & Kim, S. (2010). Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertility and sterility, 94(1), 343-349.
Garcia-Velasco, J. A., & Somigliana, E. (2009). Management of endometriomas in women requiring IVF: to touch or not to touch. Human Reproduction, 24(3), 496-501.
Hachisuga, T., & Kawarabayashi, T. (2002). Histopathological analysis of laparoscopically treated ovarian endometriotic cysts with special reference to loss of follicles. Human Reproduction, 17(2), 432-435.
Seli, E., Zeyneloglu, H. B., Senturk, L. M., Bahtiyar, O. M., Olive, D. L., & Arici, A. (1998). Basic fibroblast growth factor: peritoneal and follicular fluid levels and its effect on early embryonic development. Fertility and sterility, 69(6), 1145-1148.
Stephansson, O., Kieler, H., Granath, F., & Falconer, H. (2009). Endometriosis assisted with reproduction technology, and risk of adverse pregnancy outcome. Human Reproduction, 24(9), 2341-2347.
Vercellini, P., Somigliana, E., Vigano, P., Abbiati, A., Barbara, G., & Crosignani, P. G. (2009). Endometriosis: current therapies and new pharmacological developments. Drugs, 69, 649-675.
Cahill, D. J., & Hull, M. G. R. (2000). Pituitary–ovarian dysfunction and endometriosis. Human reproduction update, 6(1), 56-66.
Moon, C. E. M., Bertero, M. C., Curry, T. E., London, S. N., Muse, K. N., Sharpe, K. L., & Vernon, M. W. (1993). The presence of luteinized unruptured follicle syndrome and altered folliculogenesis in rats with surgically induced endometriosis. American Journal of Obstetrics and Gynecology, 169(3), 676-682.
Kitajima, M., Defrère, S., Dolmans, M. M., Colette, S., Squifflet, J., Van Langendonckt, A., & Donnez, J. (2011). Endometriomas as a possible cause of reduced ovarian reserve in women with endometriosis. Fertility and sterility, 96(3), 685-691.
Cahill, D. J., & Hull, M. G. R. (2000). Pituitary–ovarian dysfunction and endometriosis. Human reproduction update, 6(1), 56-66.
Somigliana, E., Berlanda, N., Benaglia, L., Viganò, P., Vercellini, P., & Fedele, L. (2012). Surgical excision of endometriomas and ovarian reserve: a systematic review on serum antimüllerian hormone level modifications. Fertility and sterility, 98(6), 1531-1538.
Kennedy, J. E., ter Haar, G. R., & Cranston, D. (2003). High intensity focused ultrasound: surgery of the future? The British journal of radiology, 76(909), 590-599.
Rébillard, X., Davin, J. L., Soulié, M., & Comité de Cancérologie de l'Association Française d'Urologie. (2003). Treatment by HIFU of prostate cancer: survey of literature and treatment indications. Progres en urologie: journal de l'Association francaise d'urologie et de la Societe francaise d'urologie, 13(6), 1428-1456.
Kim, B. Y., Rutka, J. T., & Chan, W. C. (2010). Nanomedicine. New England Journal of Medicine, 363(25), 2434-2443.
Park, Y., Demessie, A. A., Luo, A., Taratula, O. R., Moses, A. S., Do, P., ... & Taratula, O. (2022). Targeted nanoparticles with high heating efficiency for the treatment of endometriosis with systemically delivered magnetic hyperthermia. Small, 18(24), 2107808.
Oh, I. H., Min, H. S., Li, L., Tran, T. H., Lee, Y. K., Kwon, I. C., ... & Huh, K. M. (2013). Cancer cell-specific photoactivity of pheophorbide a–glycol chitosan nanoparticles for photodynamic therapy in tumor-bearing mice. Biomaterials, 34(27), 6454-6463.
Coccia, M. E., Rizzello, F., Cammilli, F., Bracco, G. L., & Scarselli, G. (2008). Endometriosis and infertility: surgery and ART: an integrated approach for successful management. European Journal of Obstetrics & Gynecology and Reproductive Biology, 138(1), 54-59.
Coccia, M. E., Rizzello, F., & Gianfranco, S. (2010). Does controlled ovarian hyperstimulation in women with a history of endometriosis influence recurrence rate? Journal of women's health, 19(11), 2063-2069.
De Hondt, A., Meuleman, C., Tomassetti, C., Peeraer, K., & D'Hooghe, T. M. (2006). Endometriosis and assisted reproduction: the role for reproductive surgery? Current Opinion in Obstetrics and Gynecology, 18(4), 374-379.
Benaglia, L., Somigliana, E., Vighi, V., Ragni, G., Vercellini, P., & Fedele, L. (2010). Rate of severe ovarian damage following surgery for endometriomas. Human reproduction, 25(3), 678-682.
Tummon, I. S., Asher, L. J., Martin, J. S., & Tulandi, T. (1997). A randomized controlled trial of superovulation and insemination for infertility associated with minimal or mild endometriosis. Fertility and sterility, 68(1), 8-12.
NULSEN, J. C., WALSH, S., DUMEZ, S., & METZGER, D. A. (1993). A randomized and longitudinal study of human menopausal gonadotropin with intrauterine insemination in the treatment of infertility. Obstetrics & Gynecology, 82(5), 780-786.
Marconi, G., Vilela, M., Quintana, R., & Sueldo, C. (2002). Laparoscopic ovarian cystectomy of endometriomas does not affect the ovarian response to gonadotropin stimulation. Fertility and sterility, 78(4), 876-878.
Kobayashi, H., Sumimoto, K., Moniwa, N., Imai, M., Takakura, K., Kuromaki, T., ... & Terao, T. (2007). Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan. International Journal of Gynecological Cancer, 17(1), 37-43.
Leone Roberti Maggiore, U., Ferrero, S., Mangili, G., Bergamini, A., Inversetti, A., Giorgione, V., ... & Candiani, M. (2016). A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Human reproduction update, 22(1), 70-103.
Coccia, M. E., Rizzello, F., & Gianfranco, S. (2010). Does controlled ovarian hyperstimulation in women with a history of endometriosis influence recurrence rate? Journal of women's health, 19(11), 2063-2069.
Sanchez, A. M., Viganò, P., Somigliana, E., Panina-Bordignon, P., Vercellini, P., & Candiani, M. (2014). The distinguishing cellular and molecular features of the endometriotic ovarian cyst: from pathophysiology to the potential endometrioma-mediated damage to the ovary. Human reproduction update, 20(2), 217-230.
Benaglia, L., Cardellicchio, L., Guarneri, C., Paffoni, A., Restelli, L., Somigliana, E., & Fedele, L. (2014). IVF outcome in women with accidental contamination of follicular fluid with endometrioma content. European Journal of Obstetrics & Gynecology and Reproductive Biology, 181, 130-134.
Lu, J., Wang, Z., Cao, J. et al. A novel and compact review on the role of oxidative stress in female reproduction. Reprod Biol Endocrinol 16, 80 (2018). https://doi.org/10.1186/s12958-018-0391-5
Qi, Q., Li, Y., Chen, Z., Luo, Z., Zhou, T., Zhou, J., Zhang, Y., Chen, S., & Wang, L. (2025). Update on the pathogenesis of endometriosis-related infertility based on contemporary evidence. Frontiers in Endocrinology, 16, 1558271. https://doi.org/10.3389/fendo.2025.1558271
Miller, J. E., Ahn, S. H., Monsanto, S. P., Khalaj, K., Koti, M., & Tayade, C. (2017). Implications of immune dysfunction on endometriosis associated infertility. Oncotarget, 8(4), 7138–7147. https://doi.org/10.18632/oncotarget.12577
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