Endometriosis is a common gynaecological disorder that affects nearly 10% of women worldwide. Among the various health concerns associated with it, the question, “does endometriosis cause infertility?” is one of the most pressing. This article will explore the relationship between endometriosis and infertility, bringing together insights from various sources to provide a comprehensive understanding of this complex condition.
What is Endometriosis?
Endometriosis is a condition where tissue resembling the uterine lining (endometrium) grows outside the uterus, often on structures such as the ovaries, fallopian tubes, bladder, and intestines. This misplaced tissue can cause irritation, leading to pain, scar tissue formation, and potentially, fertility problems.
Read More: What are the treatment options for Endometriosis?
Symptoms and Diagnosis of Endometriosis
A significant number of women with endometriosis experience pelvic or abdominal pain, especially during their menstrual cycle or sexual intercourse. However, some women may not show any symptoms. The only definitive way to diagnose endometriosis is through a surgical procedure known as laparoscopy.
Read More: Understanding How Endometriosis Can Cause
Relationship between Endometriosis and Infertility
Fertility Concerns and Endometriosis
Although endometriosis can make it more challenging to conceive, it does not necessarily lead to infertility. Up to 30% to 50% of women with endometriosis may struggle with fertility. The condition can impact fertility in various ways, such as causing distortion of the pelvic anatomy, inflammation, and altered hormonal environment.
Probability of Natural Conception
Even with severe endometriosis, natural conception is still possible. It is estimated that 60-70% of those with endometriosis can achieve pregnancy spontaneously. However, fertility rapidly declines after the age of 38 due to decreasing egg quality and increased rates of miscarriage and chromosomal abnormalities.
Role of Endometriosis in Pregnancy Complications
There is ongoing debate about whether endometriosis increases the likelihood of complications during pregnancy. While some studies suggest an increased risk, more research is needed to confirm these claims.
Endometriosis and Infertility: Exploring the Connection
Endometriosis and Fallopian Tube Blockage
One of the ways endometriosis can affect fertility is by blocking the fallopian tubes, where egg cells travel to the uterus. Endometriosis growths can sometimes block these tubes, making it harder for a woman to conceive.
Endometriosis Lesions and Fertility
The location and extent of endometriosis lesions can also play a role in fertility problems. A woman with only a few “spots” of endometriosis might have a different fertility experience than a woman with extensive endometriosis.
Effect of Endometriosis on In Vitro Fertilization (IVF)
Women with moderate to severe endometriosis typically experience reduced chances of achieving pregnancy spontaneously or through low-complexity assisted reproduction techniques. However, tailored treatments considering factors such as the patient’s age, degree of fallopian tube involvement, and presence of normal or abnormal male factors may involve evaluating excision surgery in some cases to eliminate endometriotic lesions and potentially facilitate pregnancy. In severe cases, however, IVF is usually considered the optimal option.
Complications Linked to Endometriosis
Adhesions and Ovarian Cysts
Endometriosis can lead to the development of adhesions, which are “sticky” areas of endometriosis tissue that can join organs together. It can also cause ovarian cysts, which are fluid-filled cysts in the ovaries that can sometimes become large and painful.
Surgery Complications
Like all surgeries, procedures to treat endometriosis carry a risk of complications1. These can range from minor issues like wound infection and bruising, to more serious risks like damage to an organ, severe internal bleeding, and blood clots.
Bladder and Bowel Problems
Endometriosis can also affect the bladder or bowel, potentially requiring major surgery. Treatment for endometriosis around or inside these organs may involve removing part of the bladder or bowel.
Read More: What are the treatment options for Endometriosis?
Treatment Options for Endometriosis-Related Infertility
Surgical Treatment
Surgical removal or destruction of endometriosis tissue can sometimes improve fertility, especially in women with moderate or severe endometriosis.
Assisted Reproduction Technologies (ART)
For those who struggle to conceive naturally, assisted reproduction technologies like IVF may be an option. The success of these treatments depends on various factors, including the woman’s age, reproductive history, overall health, and the extent of her endometriosis.
Hormonal Therapy
Hormonal contraceptives and other drugs that lower or block estrogen can help manage endometriosis symptoms. However, these treatments usually do not improve pregnancy rates.
Role of Stem Cells in Treating Endometriosis
Recent research indicates that stem cells might play a crucial role in treating endometriosis and associated infertility. The use of donor stem cells in bone marrow transplants has shown promising results, opening up a new avenue for treating endometriosis-related infertility.
Does Endometriosis Increase the Risk of Miscarriage or Ectopic Pregnancy?
Endometriosis does not necessarily increase the risk of miscarriage. While miscarriages occur in around 1 in 5 pregnancies, for women with endometriosis, the risk increases to around 1 in 4.
The risk of ectopic pregnancy, where the fertilized egg implants outside the uterus, is less common than miscarriages. However, in women with endometriosis, the risk of ectopic pregnancy is more than doubled.
Managing Endometriosis: A Multi-Faceted Approach
Importance of Early Diagnosis
Identifying endometriosis early can help manage the condition and its potential impact on fertility. If you’re experiencing symptoms of endometriosis, it’s vital to discuss them with your healthcare provider.
Lifestyle Changes
Lifestyle changes, including maintaining a healthy diet and regular exercise, can help manage endometriosis symptoms and improve overall health.
Emotional and Psychological Support
Living with endometriosis can be challenging and emotionally draining. Psychological and emotional support, either through professional counseling or support groups, can be beneficial.
Final Thoughts
While endometriosis can make it more challenging to conceive, it does not necessarily lead to infertility. With the right diagnosis and treatment plan, many women with endometriosis can achieve pregnancy. If you’re struggling with endometriosis and trying to conceive, it’s essential to have open conversations with your healthcare provider about your concerns and treatment options.
References:
https://www.nhs.uk/conditions/endometriosis/complications/
https://www.endometriosis-uk.org/endometriosis-fertility-and-pregnancy
https://www.pennmedicine.org/updates/blogs/fertility-blog/2016/august/endometriosis-and-fertility