Endometriosis is a chronic inflammatory condition affecting up to 10% of women of
reproductive age and this, depending on its severity, very often leads to
infertility. New research has shed light on the role of underlying endometritis
due to the presence of inflammatory, non-oestrogen metabolising microbiome at
the mucosal interface and this in turn leads to the activation of aggressive,
non-tolerant immune cells in the endometrium. These immune cells require the
presence of tolerance-inducing commensals such asLactobacilliso as to allow the implantation of the fertilised egg. New therapies should be
holistic and address both the dysbiosis as well as immune abnormalities. Routine
immune monitoring of the immune cells derived from the endometrium and/or
microbial profiling should recommended to better predict assisted reproduction
outcomes in these couples.