Does Endometriosis Effect on Infertility?

Endometriosis is when tissue is found outside the uterus that appears similar to the lining of the endometrium. Endometriosis may grow on the outside of your uterus, ovaries, and tubes and even on your bladder or intestines. This tissue can irritate structures that it touches, causing pain and adhesions on these organs. Pelvic pain is the most common symptom of endometriosis, but some women with the condition may also experience infertility.

Symptoms of endometriosis

  • Pelvic pain
  • Pain during intercourse
  • Painful bowl moments
  • Pain in lower back
  • Painful menstruation
  • Heavy or irregular menstrual cycle
  • Constipation and nausea
  • Infertility
  • Abdominal cramping

The inflammation and irritation caused by the endometriosis can affect fertility. Inflammation of the fimbria, which pick up the egg and transport it into the fallopian tube, causes swelling and scarring so the egg may not reach its destination. Scarring and adhesions that occur with endometriosis can block the fallopian tubes or uterus, making it difficult for the sperm to meet the egg. Endometrial tissue on the ovaries can inhibit ovulation, preventing the release of an egg.

Treatment of endometriosis

  • Pain medications: Medical therapy is effective in relieving pain associated with endometriosis. Nonsteroidal anti-inflammatory drugs or NSAIDs are commonly prescribed to help relieve pelvic pain and menstrual cramping. These pain-relieving medications have no effect on the endometrial implants or the progression of endometriosis. However, they do decrease prostaglandin production, and prostaglandins are well known to have a role in the causation of pain.
  • Hormones: Gonadotropin-releasing hormone analogs have been effectively used to relieve pain and reduce the size of endometriosis implants. These drugs suppress estrogen production by the ovaries by inhibiting the secretion of regulatory hormones from the pituitary gland. As a result, menstrual periods stop.
  • Surgery: Surgical treatment for endometriosis can be useful when the symptoms are severe or there has been an inadequate response to medical therapy. Surgery is the preferred treatment when there is anatomic distortion of the pelvic organs or obstruction of the bowel or urinary tract. It may be classified either as conservative, in which the uterus and ovarian tissue are preserved, or definitive, which involves hysterectomy (removal of the uterus), with or without removal of the ovaries.
  • Infertility treatment:  In-vitro fertilization (IVF) may be recommended for infertility treatment due to endometriosis.

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