Does Endometriosis Cause Infertility?

Endometriosis
Endometriosis is a very common gynecological disease in which cells from the inside lining of the uterus (endometrium) begins growing outside of the uterus. In a normal menstrual cycle these cells on the inside of the uterus are affected by hormones, first thickening and then shedding through menstrual bleeding. In a women with endometriosis, the endometrial cells that are growing outside of the uterus also thicken and shed during the monthly cycle. However, once they shed, they have no where to go. The body sees this bleeding as "wound" and rushes to heal it. This process causes scar tissue and adhesions to form.

Endometriosis Infertility
Unfortunately, when endometriosis spreads in a woman's reproductive organs, it often reaches the fallopian tubes, ovaries, and pelvic floor causing endometriosis infertility. Depending on the extent of the disease the scar tissue or adhesions can prevent normal egg maturation and release, prevent an egg from passing through the fallopian tubes, or a fertilized egg from implanting inside the woman's uterus. In some cases endometriosis can also release toxic substances causing harm to eggs or embryos.

One of the biggest dilemmas with endometriosis is that it can be very difficult to diagnose. Many of the symptoms of the disease are vague and may be mistaken for other conditions. Additionally, many general health care providers are unaware of the prevalence of endometriosis infertility in the female population and fail to initiate proper evaluations.

1. Laproscopy
   Laproscopy is considered the gold-standard for endometriosis diagnosis. It is a surgical procedure that allows a surgeon access to the reproductive organs with a laparoscope. Through the laparoscope the surgeon can visualize any endometrial growths and remove them if necessary.



2. Ultrasound or MRI
   A pelvic ultrasound or MRI can be used to diagnose endometrial scars or adhesions. However, both of these techniques are unable to determine the extent of the disease and therefore are not preferable unless laproscopy is not an option.



3. Hysterosalpingography (HSG)
   This radiological procedure requires that a woman receive a small amount of dye that is placed in the vagina and flows through the uterus and fallopian tubes. Once the dye is inserted then X-ray images are taken to reveal whether or not there is a endometrial blockage of the tubes which could cause infertility.

There is no end to information on the internet about how to get pregnant with "natural" endometriosis infertility treatment. However, the reality is that endometriosis infertility is a disease that requires special expertise in order to safely and effectively treat.

1. Lifestyle Modifications
   Lifestyle modifications such as diet and exercise can have an impact on endometriosis. Studies have shown that increasing exercise along with minimizing trans fats, sugar, and other unhealthy foods can reduce the inflammation with endometriosis. However, they are typically not sufficient in reversing endometriosis infertility.



2. Medications
   There are some research studies that have looked at different types of medications, particularly hormonal medications, for use as endometriosis infertility treatment. However, this can be tricky as some medications, such as those which promote estrogen, can actually make endometriosis worse. However, there is a lack of well-designed studies to demonstrate the efficiency in improving infertility when used as a sole treatment. However, several recent studies have had success with improving fertility by combining drug therapy with surgical procedures.



3. Surgery
   Depending on the extent of the disease, surgery may be recommended. The purpose of the surgical procedure is to remove any of the endometriosis and adhesions. Also, if the disease has cased damage to the reproductive organs the surgeon will attempt to repair this as well. It has been shown that women with mild endometriosis do show better pregnancy rates following surgery. However, women with more sever forms of endometriosis show only modest improvements after surgery.
   
   
4. Assisted Reproduction
   In many cases a woman may need some sort of assisted reproductive procedure to help her and her partner become pregnant. Endometriosis can cause damage to reproductive organs, reduce egg quality, damage fallopian tubes, block the release of follicles, and many other obstacles to pregnancy. Identifying what type of damage that has been caused will help determine which ART technique will be most likely to increase fertility.
   
   Intrauterine insemination, or IUI, can be done by artificially placing the partner's sperm into the uterus of the woman. In some cases, prior to an IUI treatment a woman may be given fertility drugs in order to mature multiple eggs and increase her likelihood for a successful conception.
   
   Gamate Intrafallopian Transfer (GIFT) is also a possible treatment option if a woman has healthy fallopian tubes. This involves placing both the woman's eggs and the partner's sperm into the fallopian tubes to facilitate fertilization.
   
   If other treatments have failed or if a woman's fallopian tubes have been damaged, in vitro fertilization (IVF) is the most effective endometriosis treatment option. This involves removing eggs from the mother and fertilizing them with her partner's sperm outside of her body. The embryos are then implanted in the woman's uterus for pregnancy.