Endometriosis

Endometriosis is one of the top three causes of infertility in women.

During a normal menstrual cycle the uterine lining (called endometrium) thickens in preparation for pregnancy. If you don’t get pregnant that month, your body eliminates the endometrium during menstruation. In endometriosis, for reasons still unknown by doctors, a tissue resembling the endometrium develops outside the uterus: the ovaries, fallopian tubes, or perineum. Sometimes it appears in the cervix, vagina, rectum, bladder, or intestines.

This tissue behaves like the endometrium: first it accumulates and then it is removed during menstruation. But, unlike the uterine lining, this tissue can not be deleted normally, causing irritation, inflammation and the appearance of scars. The proliferation of this tissue prevents the release of the ova or their fertilization by sperm.

Besides infertility, the signs and symptoms of endometriosis are:
– Pain during sex
– Pain on urination
– Muscle pain during menstruation
– Acute abdominal pain before or after menstruation
– Pain or chronic pelvic pain
– Menstrual flow or bleeding profusely outside menstruation
– Fatigue

Infertility Treatment

If a woman fails to become pregnant, treatment decisions for endometriosis should be more complex.
In case of severe pain caused by endometriosis in a woman who wants to become pregnant, the first treatment option for pain control is laparoscopic surgery. (Hormone therapy for endometriosis prevents pregnancy).
If infertility is associated with an easier form of endometriosis, intrauterine artificial insemination or in vitro fertilization (laboratory) is considered necessary, which lead to an increased chance of pregnancy. In a moderate or severe endometriosis, the doctor will indicate laparoscopy to see and remove the signs of endometriosis. Laparoscopic surgery can remove the pain caused by endometriosis and thereby increasing and the chance of getting pregnant. In vitro fertilization also increases the chances of pregnancy when a woman has moderate or severe endometriosis, which causes infertility.

After laparoscopy, the following approach depends on the severity of endometriosis and the woman’s age. If a woman is over 35 she has less time to get pregnant – egg quality is deteriorating and the risk of miscarriage increases with age.