• Understanding Endometriosis and Infertility

    Consultant Gynecologist Martin Hirsch discusses endometriosis and infertility, looking at what can be done to improve chances of pregnancy.

    woman with pregnancy test

    Endometriosis is a chronic multi-system condition affecting up to one in ten women. A major concern for women with endometriosis is its impact on fertility. 

    Endometriosis and fertility is a key topic. The condition can cause infertility or make it more difficult for women to conceive naturally. Understanding the relationship between endometriosis and fertility is crucial for those affected by this condition.

    How does endometriosis affect fertility?

    Endometriosis can affect fertility in several ways. The abnormal growth of endometrial tissue outside the uterus can lead to the formation of adhesions, scar tissue, and cysts in the pelvic area. 

    These adhesions can cause the fallopian tubes to become blocked or distorted, making it difficult for the egg to travel from the ovaries to the uterus. Endometriosis can also reduce the function of the ovary rendering fertility treatment less likely to be successful.

    The severity of endometriosis is not an absolute indicator for infertility. The risk of infertility does increase with the severity of the disease although some people with severe endometriosis may have no trouble conceiving.ย 

    Conversely, there are higher chances of women with minimal or mild endometriosis experiencing difficulties conceiving compared to those without endometriosis. This uncertainty can cause understandable anxiety.

    Treatment options

    For those experiencing endometriosis and infertility, therefore having difficulties conceiving, In vitro fertilization (IVF) is often recommended. IVF involves the retrieval of eggs from the ovaries, fertilization in a laboratory, and the transfer of embryos into the uterus. This procedure bypasses the fallopian tubes, which may be affected by endometriosis, and increases the chances of pregnancy. 

    If the fallopian tubes are blocked and swollen with fluid, this can reduce the success with IVF. It is common for a blocked and swollen tube to be removed by keyhole surgery prior to transferring an embryo back into the uterus.

    Surgery is another treatment option for endometriosis-related infertility. Laparoscopy, a keyhole surgical procedure, is commonly used to diagnose and treat endometriosis. During laparoscopy, the surgeon can remove endometriosis deposits, cysts, and adhesions, which may improve natural fertility. 

    Lifestyle changes can also play a role in improving fertility for women with endometriosis…

    Read the full version of this article in Issue 4 of Female Health & Fertility magazine.

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