ESR1 and Infertility: Nonetheless, TWNK, XRCC4/9 and STAR genes, related to adrenal and gonadal steroidogenesis, have been associated with syndromic primary ovarian insufficiency [29] and substantial increase in the expression of HSD3B2 and ESR1 genes in follicular eutopic endometrium from infertile females with endometriosis was predicted to have a negative outcome on estradiol pathways [30].