Endometriosis is a painful disorder, presenting with red inflamed tissue that causes the immune system to overreact and complicate conception.  When diagnosed surgery is the common treatment to remove as much of the inflamed tissue and freeing any organs ensnared in it.  Surgery can not completely resolve the issue and endometriosis can be hard to remove entirely.  One concern with endometriosis is the toxic byproducts produced by the inflamed tissue and the over responding immune system.  The toxic fluid can enter the uterus via the fallopian tubes where it can have an effect on sperm and an embryo.  Currently modern medicine does not recognize toxic pelvic fluid or offer a treatment.  This research article is one of the first to examine pelvic fluid from women with endometriosis and the possible effects on sperm.


Article researchers collected pelvic fluid from healthy women and women with endometriosis.  Sperm were exposed to the pelvic fluid and damage to the DNA was examined.  It was found significant DNA damage to sperm occurred when exposed to pelvic fluid from women diagnosed with endometriosis.  Researchers feel this could possible explain one of the mechanism behind endometriosis and problems conceiving.


Part of the work I do with clients is to stabilize the environment in the uterus.  Why?  Because the byproducts of the immune system reaction cause cellular damage to sperm and mostly importantly the embryo.  Imagine – you’re a little happy embryo looking for a place to settle in.  You would want a warm soothing environment where nothing is noisy, bright or prickly.  Toxic byproducts are the annoyance to the embryo causing the environment to be unsettling and limit the embryo’s ability to connect with the uterus.  Byproducts such as TNF and oxidative stress interact with cells in the sperm and embryo resulting in a series of after affects that damage the integrity of their cells.  Once the cells are damaged sperm/embryo’s ability to merge with others cells or trigger an appropriate cellular mechanism decreases.  The most severe damage is to DNA resulting in poor quality embryos.  The embryo and sperm have limited defenses against cellular damage and thus women have trouble conceiving. 


Couples may have excellent embryo quality, but fail to become pregnant – toxic pelvic fluid could be part of the problem.  Chinese herbs have a wonderful ability to calm the immune system, improve blood circulation, limit oxidative stress and decrease inflammation.  The change in the pelvic environment can result in pregnancy.  By addressing the environment of the pelvic area and treating the whole health presentation, women are given the best opportunity (with or without Western medical assistance) to conceive. 


Fertility and Sterility Volume 92, Issue 1, Pages 61-67 (July 2009)
The impact of peritoneal fluid from healthy women and from women with endometriosis on sperm DNA and its relationship to the sperm deformity index
Gihan Mansour, M.D and et all.

Despite the vast amount of research in the last decade, the relationship between endometriosis and infertility is not completely understood. Oxidative stress (OS) has been proposed as a possible mechanism that is involved in the pathophysiology of endometriosis by promoting growth and adhesion of endometrial cells in the peritoneal cavity. Elevated levels of reactive oxygen species (ROS) have been found to increase in the serum and peritoneal fluid (PF) of patients with endometriosis.


OS has been shown to exert toxic effects on sperm, damaging the sperm cell membrane, inducing DNA damage, and mediating sperm apoptosis. Membrane lipid peroxidation is believed to be an important mechanism that occurs in the spermatozoa as a result of exposure to excessive ROS. As a consequence of lipid peroxidation, the plasma membrane loses the fluidity and integrity associated with fertilization.  Furthermore, OS-mediated DNA damage interferes with the sperm DNA integrity required for achieving and sustaining normal embryo development.
Abnormally high levels of tumor necrosis factor-alpha (TNF-α) have been reported in the PF of females with endometriosis. TNF-α has been proposed as a sensitive marker for the nonsurgical diagnosis of endometriosis.  In vitro incubation of motile sperm with TNF-α has produced sperm chromatin and DNA damage in a concentration- and time-dependent manner.



Samples incubated with PF from patients with endometriosis showed evidence of significantly higher sperm DNA damage compared with samples incubated with PF from healthy women and controls at the three incubation periods studied. The study demonstrated significant positive interdependence between the SDI scores and the extent of sperm DNA damage both in controls and in samples incubated in PF.


After semen is deposited in the vagina, only a few thousand sperm reach the fallopian tubes, where they are maintained in a fertile state, for hours and possibly days, by interacting with endosalpingeal epithelium. As the time of ovulation approaches, sperm become capacitated and hyperactivated, which enables them to proceed toward the tubal ampulla.  At this site sperm may be exposed to PF coming through the patent fallopian tubes. Our study has demonstrated that incubating sperm with PF from patients with endometriosis for periods as short as 1.5 hours was associated with significantly higher sperm DNA damage compared with the level of damage that occurred when sperm were incubated with PF of healthy women and controls. Based on this, an assumption could be made that sperm DNA damage is induced relatively quickly in endometriosis cases and in an exaggerated manner. Throughout the study’s incubation period, the proportion of sperm with DNA damage remained significantly higher in sperm exposed to PF from patients with endometriosis compared with controls and with sperm exposed to the PF from healthy women. We are proposing that endometriosis-induced sperm DNA damage may be one of the underlying causes of reduced natural fertility in these cases.


The biological impact of sperm DNA damage may depend on the combined effects of the level of sperm DNA damage and the competence of the oocyte or early embryo to repair the DNA damage. However, it has been reported that if the damage occurs beyond a certain level, it results in a low rate of embryonic development and early pregnancy loss due to implantation failure. To complicate matters further, strong evidence exists that oocyte quality is altered in endometriosis, which may affect the oocyte’s ability to repair sperm DNA damage.