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The Link Between Endometriosis and Infertility

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Endometriosis is a condition in which endometrial tissue grows outside the uterus (this is the tissue that typically lines the inside of the uterus).  Endometriosis is a potential cause of infertility.  If the endometrial tissue grows outside the uterus, it will attach to other body parts in the abdominal cavity, including the ovaries and fallopian tubes.  This endometrial tissue, both inside and outside of the uterus, works with menstrual cycle hormones in a similar way.  This tissue swells and thickens, then sheds to start the beginning of the next cycle.  Unlike the menstrual blood from the uterus that is discharged during a period, the blood from the endometrial tissue in the abdominal cavity has no place to go.  Inflammation occurs in the areas where the blood collects and forms scar tissue.


Endometriosis and InfertilityThis scar tissue often blocks the fallopian tubes and can even interfere with ovulation.  Endometrial tissue growing inside the ovaries may even form a type of ovarian cyst called an endometrioma, which may also interfere with ovulation.  Endometriosis is considered to be a progressive disease; not only does it often get worse the longer one experiences it, but the pain also intensifies over time.  Unfortunately for many women, endometriosis can reoccur after treatment.

 

Medical history is important in diagnosing endometriosis.  A doctor will review personal information in detail, typically discussing any symptoms and concerns with a patient before performing a pelvic exam.  Typical symptoms of endometriosis include extremely painful menstrual periods, heavy menstrual bleeding, and general pelvic pain throughout the menstrual cycle or unusual pain during or after sexual relations.  Some women with endometriosis deal with irregular constipation or diarrhea that gets worse around the time of menstruation.  Endometriosis can also cause pain when urinating and, in some cases, blood in the urine.  It is possible, though, to not have any symptoms at all.

 

The results of a pelvic exam may suggest the possible diagnosis of endometriosis.  The only way to confirm a diagnosis of endometriosis is with diagnostic laparoscopic surgery (laparoscopy).  This is an outpatient procedure that involves making a small incision in the abdomen through which the surgeon inserts a tube with a special camera and, if needed, small surgical instruments.

 

To diagnose endometriosis, the surgeon will look for visual evidence of endometrial growths. If found, a biopsy of the tissue may also be performed.  The doctor will usually use the surgery to determine the severity of endometriosis, known as staging.  In mild to moderate cases, the doctor may even treat the endometriosis during the diagnostic surgery.

 

Endometriosis is classified into four stages:  minimal (stage 1), mild (stage 2), moderate (stage 3), or extensive (stage 4), based on the amount of scarring and diseased tissue found. Knowing the stage of the endometriosis is important in order to determine which treatment will be best.

 

Medications are mainly used to treat the symptoms of endometriosis, and surgery is the best option for actually treating endometriosis.  If, however, there is severe disease, then IVF may be recommended by a reproductive specialist.

 

The Endometriosis Association estimates the disease affects 5.5 million women in the United States and Canada and many millions more throughout the world.  Endometriosis is thought to be involved in 30% of infertility cases, and between 30 to 50% of women with endometriosis experience infertility.  Not every woman with endometriosis will have trouble conceiving though, and ironically, pregnancy may help with the symptoms and development of the disease.

 

If you are experiencing any of the symptoms of endometriosis, you should speak with your doctor or OB/GYN.  If you have not been successful in your attempts to conceive, and you are experiencing these symptoms, consider seeking more specialized assistance at an infertility clinic.

 

The infertility specialists and professional staff at the Center of Reproductive Medicine are well known for their high level of success in helping couples to conceive.  The infertility specialists at CORM are committed to providing the highest quality reproductive medicine, ensuring exceptional care is given to every patient/couple undergoing fertility treatment.

 


CORMFor information regarding infertility treatment and support in the greater Houston area, be sure to contact the Center of Reproductive Medicine at (281) 332-0073. The knowledgeable and friendly staff will answer your questions and provide the guidance you need.  Our goal is to provide a positive and nurturing experience for all patients.



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