Fertility Study offers hope to help Endometriosis Sufferers

A recent joint US-South Korean study has gone some way to explaining why women with endometriosis experience difficulty having children, according to the journal Science Translational Medicine.

Endometriosis is a chronic and debilitating condition that affects the cells which line the womb. It causes inflammation and painful, heavy periods. Around 1.5 million women in the UK suffer from endometriosis, and for many of these there is a strong association between the condition and infertility.

“Around 10% of women have endometriosis and up to 50% of endometriosis patients have infertility,” said Jae-Wook Jeong, co-author of the research paper.

For a long time the question of why some women with endometriosis are infertile while others are not has perplexed doctors. However, the researchers believe that they may now have discovered the answer: deficiency of a protein called HDAC3 in the womb.

The researchers discovered that if you induce endometriosis in other animals, it caused HDAC3 levels in the lining of the uterus to fall significantly. Furthermore, they found that by removing the ability for animals to produce HDAC3 they become infertile because of their inability to ready the uterus for pregnancy or to implant an embryo successfully. They also recorded high levels of pregnancy-preventing collagens in HDAC3-deprived animals.

Further work in human cells suggested HDAC3 acts on a range of genes to affect levels of proteins involved in processes necessary for implantation and preparation of the uterus for pregnancy.


The study hints at the possibility of identifying and developing possible treatment options for women who are experiencing endometriosis-related fertility options.

However, as Christian Becker, co-director of the Oxford Endometriosis Care Centre, cautioned that inducing the condition in mice and baboons is one thing, treating endometriosis in humans who develop the condition naturally is another.

…Adds to promise

The latest study adds to promise created last year after research by Northwestern Medicine was published in Stem Cell Reports in November 2018. The team was able to reprogram human bone marrow cells to morph into disease-free endometrial cells. Although it is early days, the hope is that in the future these cells will be able to be inserted into the uterine lining of endometriosis patients, thereby eliminating the condition.

Can you conceive with endometriosis?

Women with milder endometriosis have a nearly normal chance of achieving conception, and even women with the most severe endometriosis can conceive. However, the more severe endometriosis is, the less likely it is that conception can occur. This is because severer cases result in more scar tissue around the uterus.

Options for endometriosis sufferers

Studies have shown that surgical removal of cysts, scarring and nodules can increase the chances of conception and some mothers report that alternative therapies have helped. However, drug interventions show no impact on fertility rates.

Once pregnant, most women with endometriosis are expected to have a normal, uncomplicated pregnancy and give birth to a healthy baby. However, previous research has suggested that endometriosis can slightly increase the risk of Pre-eclampsia, a low-lying placenta, and preterm birth, although these complications are rare.