Endometriosis is one of the several causes related to female infertility. It consists of the presence and growth of endometrial tissue outside the uterus such as the ovaries, fallopian tubes or the back of uterus. The endometrium is the mucous membrane that lines the uterus, if the implantation occurs on the ovarian surface cysts may develop, they can become filled with blood and aquire a dark color. Endometriosis starts developing in the beginning of menstruation (menarche) but it is usually diagnosed between 25 and 35 years of age. The endometriosis evolution greatly varies from one woman to another depending on her age as well as the place where the endometrial tissue is developed.
This disease can affect woman’s fertility depending on the diagnosis and the level of disease. Over 30% of women who are affected by endometriosis can have difficulty in conceiving. Why? There are many possible reasons such as:
- Pelvic inflammation caused by endometriosis prevents the union between sperm and egg.
- It can cause pelvic adhesion by hindering the normal movement of the fallopian tubes as well as provoking their obstruction.
- Alterations in egg quality may arise.
- It may distort pelvic anatomy
- In some cases, substances can be secreted in the abdomen area which can cause difficulty with the natural fertility process.
What are the symptoms?
In 20% of cases, women who suffer from this disease do not experience any symptom. In case that the symptoms appear, they can change depending on the level of disease and the affected area. Once the woman is aware of the endometriosis she can pay attention to any of these symptoms:
- Painful menstruation (dysmenorrheal). It is the most common symptom because during this period the woman expels the endometrium (the inner layer of uterus). Pain in the abdomen and low back area may appear.
- Painful sexual intercourse (dyspareunia)
- Continuous tiredness or fatigue for no apparent reason
- It can affect the ability to conceive. Due to the damage caused to the ovaries or fallopian tubes, endometriosis can cause infertility.
However, many times this disorder is asymptomatic so regular visits to the gynaecologist are recommended. Medical history, gynaecological examination and ultrasound scan can diagnose endometriosis although the most effective way to verify its presence is through the laparoscopy technique.
Endometriosis and assisted reproduction
Women who suffer from severe endometriosis which can lead to fertility problems can use assisted reproduction treatments. Generally, women turn to IVF with own eggs according to the level of disease or if the ovarian reserve is damaged, they can opt for IVF with egg donation.