Endometriosis is a disorder of the female reproductive system in which abnormal growth of endometrial tissue (the normal lining of the uterus) is found outside the uterine cavity.
Women with endometriosis are more likely to have infertility or difficulty getting pregnant.
It is one of the leading causes of pelvic pain.
Apart from uterus, the most common sites of endometriosis include:
- Fallopian tubes
- Ligaments that support the uterus
- Space between the uterus and rectum
- Space between the uterus and bladder
Lining of the pelvic cavity
Endometriosis is diagnosed between the ages of 25 and 40 and this disorder is rare in women of menopause age.
Causes of Endometriosis
Currently the cause of Endometriosis is unknown, still there are several theories include:
- Abnormal functioning of the immune system
- Retrograde (or reflux) menstruation, in which some menstrual blood flows backward through the fallopian tubes and pelvis instead of normal expulsion
- Genetic or heredity factors
- Hormones imbalance: Endometriosis is stimulated by the hormone estrogen
- Endometrial cell transport: Sometime the lymphatic system can transport endometrial cells to various parts of the body
Does endometriosis cause infertility?
Endometriosis is considered one of the three major causes of female infertility. Up to 30% to 50% of women with endometriosis may experience infertility. The incidence of endometriosis is approximately 48 % in infertile women and 5 % in fertile women.
There are several presumed theories that reveal the role Endometriosis in reduced fertility are
Distorted anatomy of the pelvis
Adhesions of unwanted tissues ovary, fallopian tube and uterus
Scar formation / Damage/ block fallopian tubes
Inflammation of the pelvic structures
Altered immune system functioning,
Changes in the hormonal environment of the eggs
Impaired implantation of pregnancy
Altered an egg quality or eggs are not released from the ovaries each month
Symptoms of Endometriosis
The symptoms of endometriosis vary. Some women experience very mild symptoms, but others can have moderate to severe symptoms Most of the women often do not find out symptoms of Endometriosis until they have problems to conceive. The following are the most common symptoms for endometriosis:
Pelvic pain, especially during menstruation
Heavy or irregular menstruation
Pain during sexual intercourse
Infertility or miscarriage
Pain with bladder or bowel function, or intestinal pain
Chronic low back pain
Diarrhea, constipation, nausea, or bloating that worsens during menstruation
Bloody stool or urine
Killer cramps – Cramps that do not go away with NSAIDS and/or impede the activities of daily living
Diagnosis of Endometriosis Associated Infertility
Diagnosis of endometriosis is challenging as there is no specify test and scan available to detect endometriosis. Infertility Expert follows the following steps to confirm endometriosis
Detailed history of woman
Physical exam including a pelvic exam
Ultrasound – Used to create an image of the internal organs.
CT Scan: Used to scan body to detect any abnormalities.
MRI scan : This procedure used to view of an internal organ or structure of
Biopsy of suspicious tissue.
Laparoscopy is a minor surgical procedure used to determine the location,
extent and size of the unwanted endometrial growths. This is the only
procedure to verify endometriosis.
Treatment of Endometriosis
Endometriosis associated infertility is treatable. Before planning fertility management in Endometriosis patients by Certified Infertility expert should evaluated the following
Duration of infertility
Other combined causes of infertility
Severity of pain
Stage of Endometriosis (Severity of Endometriosis)
After getting enough information about the patient’s condition, Infertility Expert recommended management options and include
Laparoscopic Surgery: This surgery excises the lesion and restores normal pelvic anatomy and improves fertility rate.
Medical Therapy: Hormonal suppression therapy may improve comfort and sexual activity in women with pain. However, as most of them act through suppression of ovarian function, they are usually prescribed in women with endometriosis not desirous of fertility presently but may wish to do so in the future.
Fertility-Enhancing Treatments: This includes Controlled Ovarian Stimulation and Intrauterine Insemination.
Assisted Reproductive Technology (IVF): If patient is not getting pregnant by other therapies and surgery in mild and severe endometriosis, infertility treatment options like artificial insemination and/or in vitro fertilization (IVF) may be best alternate.
All over the world millions of women are affected by Endometriosis.Women with endometriosis are more likely to have infertility or difficulty getting pregnant. So it is important to choose well Certified Infertility Specialist to treat Endometriosis associated infertility.