Endometriosis affects fertility by causing the formation of pelvic adhesions, which are scar tissue bands that form between pelvic organs (ovaries, fallopian tubes, uterus, bladder and intestine).
These adhesions affect fertility by sticking the fallopian tubes and ovaries to other surfaces, affecting their normal function. It can also cause damage or blockage inside the fallopian tubes and reduce a woman’s ovarian reserve.
In-Vitro Fertilization (IVF) is the recommended treatment to achieve pregnancy for patients with endometriosis, as it allows our specialists to obtain the eggs directly from the patient’s ovaries. These eggs are fertilized under controlled laboratory conditions to generate embryos with a higher implantation potential which are then transferred back into the patient’s uterus.
What is endometriosis?
Endometriosis is a disease that occurs when the endometrial tissue, that normally covers the inside of the uterus, grows outside of it, generally on surfaces of organs and other places where it is not supposed to grow. This tissue appears in the form of endometrial implants.
Usually, the implants are found in the pelvic area; either on the ovaries, fallopian tubes, intestines, bladder and uterine external layer.
During menstruation, endometriotic implants become swollen and bleed just as the lining of the uterus does. The problem is this blood has nowhere to go and remains inside the abdomen, causing severe pain and sometimes forming pelvic adhesions among organs and other tissues.
Endometriosis can affect fertility in several ways:
- Pelvic adhesions affect fertility by sticking the fallopian tubes and ovaries to other surfaces, affecting their normal function.
- Similarly, endometriosis can cause damage or blockage inside the fallopian tubes, preventing sperm transportation or the transit of the fertilized egg into the uterus.
- At the ovaries, endometriotic lesions decrease egg quality as well as the number of available follicles present in them.
- Because Endometriosis can cause pain during or after sexual intercourse, many couples are forced to avoid sexual contact during the woman’s most fertile period, which understandably prevents conception.
Endometriosis main symptoms
Pain is the main symptom of endometriosis, which can manifest itself in different ways:
- Painful menstrual periods
- Abdominal pain
- Pelvic cramps
- Pain during or after intercourse.
Moreover, some women who suffer from endometriosis can experience pre-menstrual bleeding or bleeding between periods, gastrointestinal symptoms, and fatigue.
However, it is important to understand that the intensity of the pain felt by a patient is not always related to the endometriosis severity. While some women with severe endometriosis may have no symptoms, some patients with moderate endometriosis can experience intense pain.
While the exact causes of endometriosis are still unknown, many theories exist. One such theory suggests that endometriosis may be the result of retrograde menstrual flow whereby part of the tissue released by the woman during her menstrual period flows into her pelvic area.
However, it should be noted that not all women who have retrograde menstrual flow suffer from endometriosis. Other theories indicate that this condition may be the product of immunological disorders or other conditions.
Endometriosis can be hereditary and women whose mothers or sisters suffer from endometriosis are six times more likely to develop this condition.
How is endometriosis diagnosed?
Some reproductive health specialists believe that the only way to obtain an accurate diagnosis is by means of a minor surgery called laparoscopy. This surgical procedure is usually performed under general anesthesia, which entails certain risks for the patient.
At Ingenes, however, we recommend a gynecological vaginal ultrasound, which is a less invasive and equally effective method as laparoscopy to diagnose moderate or severe endometriotic lesions.
Treatments to achieve pregnancy in patients suffering from endometriosis
Endometriosis is often very painful and affects around 176 million women all over the world. Between 30 and 40 percent of those who suffer from it are infertile.
Most endometriosis cases are mild, although this disease can also be moderate or severe. Depending on the endometriosis degree and the objectives sought, treatment options range from simple medication to highly complex assisted reproduction treatments.
Whenever the patient experiences chronic pelvic pain and disabling menstrual periods, it is advisable to take painkillers and undergo oral hormonal treatment. However, when the objective is to achieve pregnancy, In-Vitro Fertilization (IVF) is the recommended treatment as it allows our specialists to obtain the eggs directly from the patient’s ovaries. These eggs are fertilized under controlled laboratory conditions to generate embryos with a higher implantation potential which are then transferred back into the patient’s uterus.