Endometriosis

Endometriosis is a chronic gynecological condition affecting an estimated 10–15% of women of reproductive age. It is a significant factor in infertility.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, such as in the ovaries, fallopian tubes, peritoneum, or other pelvic organs. This tissue responds to hormonal changes during the menstrual cycle, triggering inflammation, pain, and scar formation.

Symptoms of Endometriosis

The most common symptoms of endometriosis include severe menstrual pain, pelvic pain that can occur even outside of menstruation, pain during intercourse, and abnormal spotting or bleeding.

Endometriosis Testing

There is no single definitive test for diagnosing endometriosis. Most diagnoses are based on typical symptoms or the presence of endometriotic cysts detected via ultrasound. The most reliable confirmation comes from laparoscopy, where characteristic lesions can be observed in the abdominal cavity.

At Dextra Fertility Clinic, a specialized test using an endometrial biopsy is available to assess the presence of silent endometriosis in the uterine lining.

Impact of Endometriosis on Fertility

Endometriosis can affect fertility in multiple ways, depending on the location and severity of the disease. Pelvic inflammation caused by endometriosis can lead to scar tissue formation, which may block the fallopian tubes or reduce their mobility. This can prevent sperm from reaching the egg or hinder the fertilized egg’s journey to the uterus.

The condition can also impact ovarian function. Endometriomas, or “chocolate cysts,” in the ovaries may disrupt follicle development and egg maturation. Additionally, the chronic inflammation associated with endometriosis can alter the immune response in the pelvic area, negatively affecting both sperm and egg quality.

Endometriosis and Infertility Treatment

Infertility caused by endometriosis can be managed in various ways, depending on the individual case. Medical treatments, such as pain and anti-inflammatory medications, can alleviate symptoms but do not directly improve fertility. Surgical treatment, particularly laparoscopic removal of endometriotic lesions, may enhance fertility, especially in mild to moderate cases.

If natural conception is not successful, assisted reproductive technologies such as intrauterine insemination (IUI) or in vitro fertilization (IVF) may be necessary. In cases of severe endometriosis, IVF is often the most effective option, as it bypasses many of the obstacles caused by the condition, such as fallopian tube dysfunction.

Psychological and Social Impact

The combination of endometriosis and infertility can lead to significant emotional distress. Chronic pain, uncertainty about the future, and the challenges of fertility treatments can affect a woman’s quality of life and mental well-being. Additionally, many women with endometriosis experience delays in diagnosis and treatment, further increasing their anxiety.

Conclusion

Endometriosis is a major cause of infertility, but its effects vary widely among individuals. Early diagnosis and personalized treatment strategies can improve both fertility and overall quality of life.

Women who suspect they have endometriosis should seek specialized care and support as early as possible. If pregnancy is not an immediate goal, controlling endometriosis with appropriate medication is essential for preserving fertility. Treatment should be discontinued only when active pregnancy planning begins.