The overgrowth of tissue is only part of the reason why endometriosis interferes with fertility. Fortunately, there are treatments that can help.
Understanding Endometriosis
The endometrium is the superficial lining of the uterus whose role it is to provide a place for a fertilized egg to implant. During the course of a woman’s cycle, the lining will thicken in preparation for an embryo. If pregnancy doesn’t occur, the lining breaks down and is shed during menstruation.
With endometriosis, the lining will grow beyond the uterus. This overgrowth of tissue primarily forms in the pelvic region on or around the ovaries. It can also develop less commonly near the rectum, vagina, fallopian tubes, or even in the urinary or gastrointestinal tracts. In rare instances, it may form in farther reaches of the body, including in the lungs, arms, or thighs.
Even though this tissue overgrowth is well outside of the uterus, it is still governed by the same hormonal changes of the menstrual cycle. As such, it will thicken, break down, and bleed. Yet, unlike the endometrial lining of the uterus, these tissue deposits can’t be expelled vaginally. Instead, they build up over time and form cysts, adhesions, and scar tissue.
Symptoms of endometriosis can include:
General pelvic pain, even when not menstruating Painful periods Painful intercourse Heavy periods or spotting between cycles Irregular cycles Painful urination and bowel movements, especially during your period
One of the more distressing aspects of endometriosis is the increased risk of infertility. Even women who experience no outward symptoms may only learn they have endometriosis during the course of an infertility evaluation.
How Endometriosis Causes Infertility
While endometriosis is thought to be involved in 30 percent of infertility cases, it is still not entirely clear how they are connected.
While it might be fair to assume that the development of adhesions and scarring can directly interfere with conception, infertility can result even in women where there is no obvious obstruction.
Even from the point of view of trying to conceive, endometriosis can make sexual intercourse painful, if not unbearable, in some women. Moreover, the pain tends to only worsen during ovulation.
Treating Infertility in Women With Endometriosis
Treating infertility in women with endometriosis typically involves either the removal of tissues interfering with conception, the use of traditional assisted reproductive techniques, or both.
If painful intercourse is a significant barrier to conceiving, the surgical removal of tissue overgrowth will almost certainly provide relief.
Success rates vary and depend largely on how far the disease has progressed. Women with mild to moderate endometriosis tend to have greater success following surgery than those with advanced disease.
If surgery proves unsuccessful in either case, IVF remains a strong option.
A Word From Verywell
If you have endometriosis, it is best to have it evaluated if you and your partner are planning to conceive. On the other hand, if you are having infertility issues and have not been diagnosed, discuss the option of having a laparoscopic evaluation with your gynecologist or fertility specialist. Our Doctor Discussion Guide below can help you start that conversation.
It’s important to remember that not every woman with endometriosis will have trouble conceiving. If and when you do get pregnant, having endometriosis won’t generally affect the pregnancy. In fact, hormonal changes caused by pregnancy can often lessen symptoms and progression of the disease, albeit temporarily.
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