Figure 3.

Overview of main mechanisms contributing to impaired implantation in endometriosis and autoimmune diseases. The presence of endometriosis or autoimmune diseases, or a combination of both, leads to increased inflammation and immune activity, which in turn might negatively impact both oocytes maturation/embryo development and endometrial receptivity, resulting in a disrupted endometrium–embryo crosstalk at the implantation site. Immunological and inflammatory mechanisms implicated in endometriosis (E) and autoimmune diseases (A) are outlined in dashed boxes. Abbreviations: FF, follicular fluid; ROS, reactive oxygen species; uNK, uterine natural killer.