Endometrial Dysfunction in Women with Ovarian and Uterine Tumors: What Is Known and What Should Be Learned?

Multimorbidity is a key global trend across healthcare fields, including gynecology. It is strongly associated with an overall poorer health status. Statistics indicate that in the 21st century most women experience at least one gynecological disease. Meanwhile, there is a consistent increase in the prevalence of obesity associated with chronic inflammation and hyperestrogenism. Alongside other factors, it leads to a growing prevalence of hyperproliferative diseases of the female reproductive system (FRS), encompassing both benign and malignant conditions. While advanced-stage malignant tumors can be linked to missed detection and wrong checkup strategies, benign neoplasms can compromise the ovarian reserve and thus cause major concerns. The prevailing benign FRS tumors are uterine fibroids (UFs) and benign ovarian tumors (BOTs), including serous and mucinous cystadenomas. It appears that an increase in certain benign FRS tumors is occurring in parallel with a rise in infertility (especially "unexplained infertility") and reproduction failures, potentially associated with endometrial dysfunction. Thus, the endometrium is currently considered a critical area of research due to its vital role as the site of blastocyst adhesion and implantation, especially in patients with comorbidities. In this context, this article highlights the significance and pathophysiological characteristics of UFs and BOTs and their impact on defective endometrial receptivity.