Endometriosis is a disease that affects the female reproductive system due to the development of tissue that usually grows inside the uterus beginning to grow outside the uterus in other areas of the body. The tissue affected by endometriosis is usually denominated endometrial patches, implants, nodules, or lesions, and they can grow on or under the ovaries, on the fallopian tubes, which carry egg cells from the ovaries to the uterus, behind the uterus, on the tissues that hold the uterus in place, on the bowels or bladder, and in rare cases, on the lungs or in other parts of the body.

Pain and infertility are the two main symptoms of endometriosis, but patients can also experience painful, debilitating menstrual cramps, pain during or after sex, pain in the intestine or lower abdomen, painful bowel movements or painful urination during menstrual periods, heavy menstrual periods, premenstrual spotting or bleeding between periods, painful bladder syndrome, digestive or gastrointestinal symptoms similar to a bowel disorder, as well as fatigue, tiredness, or lack of energy.

Causes for Endometriosis-Related Infertility

“The relationship between endometriosis and infertility has been debated for many years. In normal couples, fecundity is in the range of 0.15 to 0.20 per month and decreases with age. Women with endometriosis tend to have a lower monthly fecundity of about 0.02–0.1 per month. In addition, endometriosis is associated with a lower live birth rate,” state the authors of the study “Endometriosis and Infertility.

It is known that women who suffer from endometriosis are 30 to 50% more likely to experience infertility, but the exact causes are not yet understood. Research advancements have hypothesized that the correlation between endometriosis and infertility is related to distorted pelvis anatomy, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system and peritoneal function, endocrine and ovulatory abnormalities, altered hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality.

Treatment for Infertility Due to Endometriosis

There is currently no cure for endometriosis, but there are treatments designed to address pain and infertility related to the disease. In the case of infertility, the first therapeutic option is usually a laparoscopy, a surgical procedure during which the surgeon removes or vaporizes the endometrial patches in order to improve fertility in women with mild or minimal endometriosis. However, it is not guaranteed that women can conceive after the surgery. “If pregnancy does not occur after laparoscopic treatment, in vitro fertilization (IVF) may be the best option to improve fertility,” explains the National Institutes of Health (NIH).

“Taking any other hormonal therapy usually used for endometriosis-associated pain will only suppress ovulation and delay pregnancy. Performing another laparoscopy is not the preferred approach to improving fertility unless symptoms of pain prevent undergoing IVF. Multiple surgeries, especially those that remove cysts from the ovaries, may reduce ovarian function and hamper the success of IVF,” it adds about IVF, which is a method based on the combination of sperm and eggs in a laboratory to make an embryo.

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