Which uterine concern is listed as a factor that can affect implantation and contribute to subfertility?

• A. Endometriosis
• B. Adenomyosis
• C. Fibroids
• D. Ovarian cyst

Answer: (A)

Endometriosis can impair implantation by creating a hostile pelvic and uterine environment that reduces endometrial receptivity. The inflammatory milieu, immune dysregulation, and cytokine changes associated with endometriosis can alter how the endometrium supports embryo attachment and invasion, making implantation less likely. In addition, pelvic adhesions and distorted pelvic anatomy from endometriosis can interfere with embryo transport and proper embryo–endometrium interaction, contributing to subfertility. Ovarian cysts are not a uterine issue and affect fertility mainly through ovarian function, while fibroids or adenomyosis can impact implantation when they distort the uterine cavity or alter the uterine environment, but endometriosis is a recognized factor that directly lowers implantation potential through endometrial receptivity and inflammatory changes.