Can Endometriosis Lead to Infertility?
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If you are diagnosed with endometriosis, you may wonder whether it will affect your chances of starting a family. The seriousness of this condition depends on several factors. It is important, however, to keep in mind that many women with endometriosis are still able to become pregnant naturally, even those whose case is more severe.

What is endometriosis?

Little known until recently, endometriosis is more and more talked about in the media. This painful disorder that, if left untreated, can seriously affect a woman’s daily life, is actually quite common, affecting 10 – 20% of women of reproductive age.

Endometriosis occurs when the tissue that lines the uterus (the endometrium, which is responsible for menstruation), spreads and starts to grow erroneously outside of it, for instance on the pelvic lining, ovaries, intestines, the Fallopian tubes or the bladder.

The problem is that the displaced endometrial tissue can cause inflammations, cysts, scar tissue or nodules, and cause pain that can sometimes be intense. These things, if left untreated, can damage the reproductive organs and lead to infertility.

What are the symptoms of endometriosis?

Symptoms of endometriosis, as well as the intensity of the pain it causes, can vary between women. In fact, some women will experience symptoms only very rarely, or not at all.

Symptoms of endometriosis include:

  • Pain during one’s period, irregular and heavy periods;
  • Pain during sex;
  • Pain during ovulation;
  • Pelvic pain;
  • Painful bowel movements or bleeding from the bowel;
  • Tiredness;
  • Back pain;
  • Depression;
  • Infertility.

If you experience any of the above symptoms it’s important that you seek advice from your doctor, whether you are thinking about having a baby or not.

Can endometriosis affect my fertility?

Though endometriosis is sometimes linked to infertility, scientists are still not sure why and to what extent. However, we do know that 30-40% of women who are infertile have endometriosis. Importantly, we also know that the disease doesn’t necessarily provoke infertility and, in fact, most women with endometriosis can still become pregnant naturally.

There is a correlation between the stage that the disease has reached (mild, moderate, or severe) and the risk of infertility. Women with mild endometriosis are less likely to have trouble conceiving because of this condition. In fact, causes of infertility due to mild endometriosis have not been established yet.

However, in more advanced stages, scar tissues, adhesion and distortion of pelvic anatomy can occur and make it harder to get pregnant. If the Fallopian tubes are damaged or blocked because of endometriosis, it will prevent the egg from reaching the uterus and being successfully fertilised. Cysts can also develop in ovaries and reduce the odds of becoming pregnant.

Sometimes, endometriosis can damage the eggs in the ovaries. This causes a decrease of the ovarian reserve, which can make it harder to fall pregnant.

What are the treatments for endometriosis?

Medical drugs can be prescribed to relieve pain or reduce the development of the displaced tissue. However, there is currently no cure for endometriosis. If you are not planning to get pregnant now, your doctor might recommend that you take birth control pills in order to stop both ovulation and any endometriosis-related pain that you might be experiencing. You might also be advised to take progestogens that will help reduce the growth of the endometrial tissue.

In case of advanced endometriosis, surgery can be recommended to remove cysts, adhesions and nodules.

What fertility treatments are available for those with endometriosis?

Treatments for endometriosis must be adapted individually as symptoms vary from woman to woman. To find the right treatment, doctors might consider the stage of the disease, the age of the patient, the location of the endometrial tissue or any symptoms that the woman might be experiencing. Treatments will also depend on whether or not the patient has been diagnosed with any other fertility problems.

Techniques such as controlled ovarian hyperstimulation with intrauterine insemination (IUI) or in vitro fertilisation (IVF) can be recommended to facilitate pregnancy.

Can endometriosis affect my pregnancy?

While endometriosis can make it harder to become pregnant, pregnancy should usually progress normally. However, you might experience more pain during the first trimester. Apart from that, any pain should subside but may come back following the birth, when your periods return.