Endometriosis and Infertility

endrimetriosisEndometriosis is a condition that often leads to painful periods, pelvic pain and infertility, with symptoms ranging from mild to severe. Though exact numbers are not known, it is estimated that about 1 in 5 of all women between the ages of 25 and 40 develop some degree of endometriosis.

What is endometriosis?

Endometriosis occurs when the tissue that is normally found inside the uterus, typically known as the endometrium or uterine lining, also grows outside of it. The cells that make up the uterine lining are ‘sticky’ and when it grows outside of the uterus, it causes the surrounding structures and tissues to stick to it.

As hormones change throughout the menstrual cycle, the endometrial tissue will break down leading to potentially painful adhesions and scar tissue. This scar tissue may end up blocking the fallopian tubes thus causing infertility.

In the ovaries, some women develop endometriomas, or chocolate cysts. These cysts are not usually cause for concern and occur when endometrial tissue grows inside the ovary. They’re known as chocolate cysts because they are typically filled with dried blood, making them brown in appearance.

Though there is no known cause of endometriosis, it often runs in families.

Some women develop endometriosis and don’t even realise it. In these cases, there really isn’t much to be done – and it may not affect fertility. However, women that do exhibit symptoms typically experience pain just before, during, and after menstruation, often with heavy bleeding. This pain may be quite debilitating and could even happen during or after intercourse, bowel movements, or urination. The symptoms are generally associated with where the endometrial tissue is growing.

Endometriosis and infertility

In many cases, the first – and sometimes only – symptom of endometriosis is difficulty becoming pregnant. Endometriosis can make the pelvic environment less optimum for embryo implantation and inhibit ovulation due to the extra tissue, possible adhesions, and scarring. The good news is, with treatment, pregnancy is possible for most women with endometriosis.

Often, women that have been diagnosed with endometriosis but are not ready to conceive are prescribed birth control pills, typically after endometriosis surgery. The pill can reduce menstrual cramping and help prevent the recurrence of endometriosis, which can help preserve fertility.

Pregnancy does sometimes occur naturally in women with endometriosis, particularly those with very mild or no symptoms; however, in those that have more severe symptoms or continued infertility even after treatment for endometriosis, in vitro fertilisation (IVF) is an excellent option for conceiving a baby – either with the woman’s own eggs or those from an egg donor.