Proposed mechanisms through which endometriosis may affects women's fertility are the following:

• Mechanically, via adhesions, immotile ovaries, tubal blockage etc.

• Ovulation disorders such as anovulation, poor luteal phase and/or luteinized unruptured follicle syndrome.
• Dysfunctional fallopian tubes due to toxic factor caused by the condition, such as prostagladins.
• Reduced implantation potential of the embryo due to integrins and other embryotoxic factors produced by the condition.
• Modified immune response due to high T, B and NK counts.
• Pelvic inflammation which can lead to high levels of IL1, TNF and prostaglandins.