Endometriosis is a common, treatable disease that affects over six million women worldwide and is known to be present in thirty percent of women with infertility. If detected and treated in a timely manner, endometriosis does not have to affect your fertility success.
Endometriosis & Pain
One of the most frustrating aspects of endometriosis is that symptoms are wide-ranging. Some women are unaware they even have it. A woman diagnosed with ‘unexplained infertility’ may actually be experiencing endometriosis.
For others, pain is a key indicator – and can be moderate to severe.
This is why it is so essential for patients to get an accurate diagnosis of the disease.
What Is Endometriosis?
In endometriosis, the normal uterine lining (called the endometrial lining) is in an abnormal location. Normally, the uterine lining is shed through the cervix during menstruation. With endometriosis, however, the lining is shed in the other direction – down and out the end of the fallopian tubes, where it can surround the ovaries and nearby structures.
Exactly like a normal uterine lining, these cells grow and ‘menstruate’ every month, causing local inflammation and scar tissue. Over time, the areas of endometriosis can also lead to pain and infection. If the condition is untreated, the uterine lining can grow to block the Fallopian tubes and ovaries, preventing a woman from becoming pregnant.
Endometriosis And Infertility
Many patients with endometriosis are led to their diagnosis through fertility testing, as it affects reproductive health.
It can:
- Lead to scarring or adhesions in the pelvis involving the ovaries and Fallopian tubes
- Damage or blocks Fallopian tubes and impedes the journey of the egg to the uterus
- Cause collections of endometriosis on the ovaries, called ‘endometriomas’
Some patients experience zero or minimal symptoms of endometriosis. Without the presence of symptoms, many women carry the diagnosis of ‘unexplained infertility’ when they actually have endometriosis.
If symptoms are present for you, we strongly suggest you seek the advice of a fertility specialist so you can be properly evaluated and receive an accurate endometriosis diagnosis.
When present, symptoms can include:
- Infertility
- Painful menstrual cramps/periods
- Pain after sexual intercourse
- Painful bowel movements
- Lower back pain
- Abnormal menstrual bleeding
How We Diagnose Endometriosis
Endometriosis cannot be confirmed from symptoms alone. In-depth inspection and tests are a necessary component to enable your doctor to confirm a diagnosis, in addition to gathering information about your medical history. Depending on your individual case of endometriosis, your doctor may recommend one or more of the following tests:
- A pelvic exam to assess pelvic tenderness or collections of endometriosis
- Pelvic ultrasound to show collections of endometriosis
- Laparoscopy: an outpatient surgical procedure and the only sure way of confirming the presence of endometriosis
In order to determine which treatment is appropriate for endometriosis, doctors classify each condition as either Minimal (stage 1), Mild (stage 2), Moderate (stage 3), or Extensive (stage 4), based on the amount of scarring and diseased tissue found at the time of laparoscopy.
Your doctor will create a personalized treatment plan that regulates your symptoms and maximizes your chance of a successful pregnancy.
Treatment Options
Successful treatment options include:
IVF
IVF is often recommended as a first-line treatment when endometriosis is causing infertility.
Laparoscopy
While severe pain can be an indication that endometrial growths are present, one of the most accurate methods of detection is through diagnostic laparoscopy, a minor surgical procedure, in this way, any endometriosis lesions can be easily identified and the endometriosis diagnosis confirmed.
During this time, we can also remove any endometrial tissue that may be present on your ovaries or fallopian tubes.
Oral Medications
Most medical approaches use medications that reduce your body’s estrogen production which, in turn, stops the growth of endometriosis. Pregnancy, however, is not possible while these medications are being used.