Experimental evidence for failure to implant as a mechanism of infertility associated with endometriosis

The effect of endometriosis on pregnancy, from ovulation through day 14 of pregnancy, was studied in an animal model previously developed and validated with the use of the rabbit. Endometrial tissue was implanted surgically in rabbits and allowed to grow for 11 weeks without hormonal supplementation. The animals were artificially inseminated with semen from bucks with established fertility and human chorionic gonadotropin was administered to induce ovulation. The animals were put to death 1, 4, 8, or 14 days later. The number of corpora lutea and fertilized ova was not affected through day 4. However, on days 8 and 14, a significant reduction in the number of normal fetuses was observed. In a second experiment peritoneal fluid from animals with endometriosis was transferred to normal rabbits 1 day before artificial insemination. A significant reduction in the number of normal fetuses was observed. These studies suggest that failure of nidation due to the maternal environment may be a major factor in infertility associated with endometriosis.