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According to the American Society for Reproductive Medicine (ASRM), Endometriosis can influence fertility in several ways: distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, changes in the hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality The exact reasons why endometriosis causes infertility are not fully understood

It is now known that DES can be caused by a non-exhaustive list of factors which include autoimmunity, hormonal imbalance, deleterious environmental settings and many more

Goh CL, Tang MBY, Briantais P, Kaoukhov A, Soto P