Endometriosis Affects Fertility
Studies show that women who have endometriosis may have a harder time getting pregnant than other women. Up to 50 percent of women who are having a hard time conceiving may have endometriosis.
Even a mild case of endometriosis can affect fertility. However, having endometriosis does not mean that you won’t be able to have a baby.
It just means that you need to be prepared if you and your partner don’t conceive right away. Depending on how severe your endometriosis is, you may eventually conceive naturally or you may require surgery or ASR, assisted reproductive technologies.
What is Endometriosis?
Your uterus is lined with a thin layer of tissue known as the endometrium. Normally the endometrium only grows inside of the uterus.
Endometriosis occurs when this lining starts to grow on the outside of the uterus on to the reproductive organs, usually on the ovaries or fallopian tubes.
Less commonly the endometrium will grow on the bladder, rectum, or intestines.
When menstruation happens the lining of the uterus is expelled out through the vagina, however, blood from the endometrium that is growing on the outside of the uterus is not able to be expelled in this way.
Consequently, the monthly bleeding that occurs in this endometrium tissue causes the growth of scar tissue, cysts, and lesions leading to a thickening of tissue.
This can lead to infertility problems as well as a great deal of discomfort when menstruating.
Endometriosis Discomfort and Pain
Some women will have a little discomfort from endometriosis while others will experience a lot of pain both before and during their period. After menopause, the symptoms of endometriosis usually diminish.
There are a few common symptoms of endometriosis, the severity of which will depend on where the endometrium tissue is growing, how deeply it’s implanted, and how long a woman has had endometriosis.
Some of these common symptoms include:
- Painful menstrual cycles.
- Abnormal or heavy menstrual flow.
- Pain during sexual intercourse.
- Pain in the pelvic area.
- Pain when ovulating.
- Problems with infertility.
- Frequent and/or painful urination during the menstrual cycle.
If you’re having problems with fertility and have any of the above symptoms it’s important that you talk to your doctor about your treatment options.
To determine whether or not you have endometriosis, your doctor will start by doing a pelvic exam when you’re menstruating to look for thickening in the pelvic region and to check to see if there are any cysts present.
You may require an ultrasound for an accurate pelvic exam. To get a definite diagnosis of endometriosis you’ll undergo a laparoscopy. This procedure is done when you’re menstruating.
The laparoscope (a thin tube with a light on the end) will be inserted into a small incision near your navel. The surgeon will then be able to determine the location, size, and a number of growths that are present.
Laparoscopy is also used to access any damage to your fallopian tubes and ovaries. This is the first step in determining whether endometriosis and fertility are a direct connection for your inability to conceive.
How Endometriosis Causes Infertility
Endometriosis affects a woman’s infertility in a variety of ways.
The main causes of endometriosis and infertility include the following:
- Movement of the egg through the fallopian tube is hindered by adhesions in the pelvic area.
- Movement of the egg through the fallopian tube is inhibited by the chemicals that are produced by endometriosis.
- Pelvic inflammation caused by endometriosis results in the cells that attack and shorten the life span of the sperm.
- Poor quality of eggs.
- The ovaries don’t release the eggs every month, also known as anovulation.
If the fallopian tubes and ovaries are damaged by endometriosis, then a woman’s ability to conceive will be significantly reduced. This will also have an effect on the movement of the sperm and egg.
Endometriosis will also affect the movement of the sperm and egg even if the fallopian tubes and ovaries have not been damaged.
When the ovaries are covered with adhesions it can be difficult if not impossible for the egg to be released from the ovary so it can be fertilized.
This type of damage is generally only found in those women who have moderate to severe cases of endometriosis.
Treating Endometriosis to Improve Fertility
Using hormone medication is not an option for women diagnosed with endometriosis. Studies show that drugs do not improve fertility even in mild to moderate cases of endometriosis.
The most successful method of treatment for moderate to severe endometriosis is surgery. During an investigative laparoscopy, surgeons will often remove any abnormal tissue and growth.
This way you may be able to avoid going through the procedure again in the future. If your fallopian tubes are blocked, tubal flushing may be an option to increase your chances of conceiving naturally.
If within a year after having laparoscopic surgery you still haven’t gotten pregnant, it may be time to talk to your doctor about other infertility options such as IVF (in vitro fertilization) or artificial insemination.