INFERTILITY AND ENDOMETRIOSIS

Endometriosis is a disease that affects women of reproductive age, and may be associated with pelvic pain and infertility. It is a benign condition, but can be debilitating in terms of pain as well as reduced fertility in women who suffer from it.

Endometriosis is basically the growth of endometrial tissue (lining of the uterus) outside the uterus. Normally, the uterine lining is only found inside the uterus, whereas in endometriosis, the tissue may grow outside the uterus in locations such as the ovaries, in the abdominal cavity, and sometimes in areas such as between the vagina and rectum.

Pain and/or infertility may not be present in every patient, but there is certainly an association with difficulty conceiving. Even with severe endometriosis, conception is still possible, although chances are reduced. With mild and moderate endometriosis, women have an almost normal chance of conceiving.

Endometriosis is diagnosed by laproscopy, where the insides of the body and reproductive tract are examined with a scope.

TREATMENT

Drug treatments have not been found to improve fertility. However, the removal of cysts, adhesions and nodules during surgical treatment has been found to increase chances of conception. Some women find that complementary treatments help; however, there is no scientific evidence of this and it varies from individual to individual. Endometriosis can cause delay in getting pregnant, but once you are pregnant, pregnancy is expected to be no different from normal. There are reports of women who had more pain in the first few months of pregnancy. In general, pain improves, but may return after giving birth as periods return.

Birth control pills help relieve pelvic pain in many women, including those with endometriosis.

Women whose symptoms continue despite the pill should discuss laparoscopy which can often be treated surgically at the time of the laparoscopy. Surgical treatment for endometriosis has been shown to improve fertility, but women not ready to become pregnant are encouraged to resume the pill to prevent endometriosis from recurring. Stronger medications, such as leuprolide acetate, are effective to treat pain, but not infertility, related to endometriosis.

Dr. Annie

Physician, mom and wife

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