Endometriosis and Fertility


Wondering about the causes of infertility? Endometriosis is one of them.

You may have heard the word a lot of times but what exactly is endometriosis? Let’s have a look. The inside of the womb of a woman is lined by a special layer of tissue called endometrium. It is the same layer part of which sloughs off during your periods and is expelled with the blood. Now in a bit abnormal fashion, women suffering from endometriosis have this lining which is supposed to line inside of their uterus have it grown out to line the outside of it and to line the ovaries, fallopian tubes and the tissues in the vicinity of the ovaries and the uterus. As a consequence of this structural abnormality, the patients suffer from two major issues. One is infertility and the other is a pain in the pelvis. Menstrual abnormalities often accompany this pathology and there can be symptoms related to bowel and urine as well. However, in quite a number of cases, there can be no symptoms at all. In Australia, 30% of women who have infertility do have endometriosis as well.



Effects on fertility

Now let’s have a look on how endometriosis can affect your fertility.  Structural and pathological changes brought about by endometriosis can adversely affect fertility. Inflammation is one of those pathological changes. Inflammation of the fimbria, parts of your fallopian tubes which receive the eggs and convey them to the fallopian tube, causes their enlargement due to swelling and subsequently fibrosis leading to scarring withholding the egg debarring it from reaching its destination. Furthermore, this inflamed environment also destroys the potency of both the egg and the sperm rendering them incapable of fertilization.  As the disease advances, inflammation of all the involved tissues leads to the process of fibrosis and adhesion formation between them rendering the whole system incapable of housing a pregnancy. 


Effects on pregnancy

The next question which might come into your mind is once you conceive, is your pregnancy a normal one. Well, in many cases it is, but it should definitely be taken as a high-risk pregnancy because depending upon the severity of your endometriosis, you may have structural and functional abnormalities which may predispose your pregnancy to a risk. Some studies have shown an increased risk of miss carriages associated with endometriosis.  Endometriosis can even lead to an ectopic pregnancy in the first place.  But all you need to do is to be a little bit more cautious if you have endometriosis and you conceive. With proper medical care and antenatal follow-ups during the pregnancy, there is nothing much to worry about. 


Treatment options

However, despite all these hindrances, the good news is that women do conceive fortunately, and more, fortunately, pregnancy leads to an improvement in the course of disease of endometriosis. The hormones produced naturally due to pregnancy ease out endometriosis a lot leading to its partial and sometimes full resolution. In cases of severe forms of endometriosis, however, pregnancy cannot occur and a laparoscopic surgery is required.  The first few weeks following the surgery carry the best chances of conception. Later on, breastfeeding and the use of birth control pills both keep a check on the development of endometriosis again and both should be exercised till the woman wants to conceive again. In such cases, breastfeeding is weaned off and birth control pills are withheld. In case this does not help, you can again take the help of laparoscopic surgery. So keep your hopes high, there is a lot which can be done to ease out your endometriosis and to ensure you get a baby, a healthy one.