Endometriosis
Surgery is more effective than medicinal intervention for addressing infertility associated with endometriosis. Surgery attempts to remove endometrial tissue and preserve the ovaries without damaging normal tissue. In-vitro fertilization (IVF) procedures are effective in improving fertility in many women with endometriosis.
Endometrium
The normal dominance of Lactobacilli in the vagina is seen as a marker for vaginal health. However, in the uterus this much lower population is seen as invasive in a closed environment that is highly regulated by female sex hormones, and that could have unwanted consequences. In studies of endometriosis "Lactobacillus" is not the dominant type and there are higher levels of "Streptococcus" and "Staphylococcus" species. Half of the cases of bacterial vaginitis showed a polymicrobial biofilm attached to the endometrium.