RESUMO
The purpose of this review was to systematize the data on the effect of endometriosis on the fertility index, the course of pregnancy, and the modern diagnosis of changes the endometriotic implants during pregnancy. There are many factors that can potentially affect fertility in patients with endometriosis: anatomical changes in the pelvic floor, impaired transport function of the fallopian tubes due to the formation of adhesions, impaired steroid and folliculogenesis, anovulation and peritoneal changes that contribute to the formation of a harmful prooxidant microenvironment, which can affect the quality and quantity of oocytes and cause a violation of the susceptibility of the endometrium. If the patient with endometriosis still managed to get pregnant, then the problem of maintaining this pregnancy arises even more. The data indicate that pregnancy has a positive effect on the symptoms of endometriosis, and also has a beneficial effect on the growth rate and relapse rate of endometriosis, and may also cause a regression of the formed endometriotic implants. However, data on the effect of pregnancy on endometriosis are contradictory, and pregnancy in women with endometriosis does not always lead to the disappearance of symptoms and a decrease in the size of endometrioid lesions. Moreover, there is growing evidence that endometriosis can affect pregnancy outcomes. Currently, it is impossible to predict changes in the endometriotic implants due to insufficient knowledge about the pathogenesis of this disease. A deeper understanding of the pathogenesis should help prevent hasty obstetric decisions that can lead to iatrogenic diseases in newborns, and patients should be informed about possible complications during pregnancy when planning a birth.