Effects of Endometriosis on Fertility

1.04.2010 | By: T. B.

This is a rather unknown disease, but it’s recommended that you read more about. It’s a dangerous, but curable disease.

The exact cause of endometriosis is still unknown. (Photoxpress)

What causes endometriosis?

The exact cause of endometriosis is still unknown. The disease manifests itself when the uterine mucosa appears in the uterine cavity as well as other places – it can often appear in the abdominal cavity, ovaries, fallopian tubes, bladder and connective tissue. Motherhood and menopause hinder the development of the disease. Tissue changes in cycles in a woman’s body and thus the problems associated with the diseases also arise in cycles. The uterine mucosa is peeled from the uterine cavity every month and the same happens with the tissue outside the uterus. Endometriosis may join organs to each other (adhesions), which changes their functions.

If a mother had endometriosis, a daughter is very likely to have it as well. (Photoxpress)

How common is endometriosis?

With an ultrasound scan, particularly the vaginal ultrasound examination, it has been found that endometriosis is much more common than initially estimated. If a mother had endometriosis, a daughter is very likely to have it as well. More than a tenth of women have endometriosis, which can be associated with a severe pain, and according to estimates, every second young woman who complains about severely painful periods has the disease. It’s also the cause of infertility in a third of women who are infertile.

Symptoms of endometriosis

Painful periods are the most typical cyclic symptom of endometriosis. The pain felt in the pelvic cavity can already appear before menstruation and can last several days after menstruation. Pain also appears during ovulation or sexual intercourse, as well as when digesting food or passing urine. Aside from the pain, typical symptoms are severe bleeding (sometimes heavier than usual bleeding or bleeding during a cycle) and infertility.

An operation is still the most effective method to treat endometriosis. (Photoxpress)

Treatment of endometriosis

The disease depends on particular hormones. This means that the patient’s well-being is affected by pregnancy and menopause. Hormones influence the development of endometriosis as well as cause that the diseases disappears. Hormonal drugs, such as contraceptive pills, the derivatives of male sex hormones without distinctive male sexual effects, the pregnancy hormone and progesterone improve the condition temporarily, since endometriosis reappears if the treatment is interrupted.

Endometriosis causes no problems during pregnancy. (Photoxpress)

Removal of excessive tissue, i.e. an operation, is still the most effective therapy. Today this procedure involves a small cut, which means that a woman receives a short treatment. With new diagnostic tests, laparoscopy, the disease can be detected earlier. These diagnostic tests also enable the so-called conservative treatment. An organ and its function remain undamaged. Sometimes, however, a larger cut is necessary if a surgeon establishes during an operation that the laparoscopic procedure isn’t sufficient. If surgery is performed without causing damage to the reproductive system, the latter's function is well restored irrespective of the stage of the disease. Thus 60% of women who had successful removal of endometrioses give birth within a year or two.

After a surgical procedure there’s still a chance of endometriosis recurrence, but the disease is only rarely incurable.

How does endometriosis affect fertility?

Half of women with proven endometriosis have no problems with infertility. Endometriosis causes infertility in two ways. Not long ago women with endometriosis simply had the uterus removed, which meant that they could no longer have children. Today, the removal of the uterus and both ovaries is still a solution for patients with the worst forms of the disease, but, as gynaecologists say, that’s really the last solution to be considered. Endometriosis is detected in 30% of infertile women. The tissue of the uterine mucosa often obstructs the pathway of an egg. Doctors advise women to decide on a baby as soon as possible because the disease can worsen, reducing the chances of conception. Endometriosis causes no problems during pregnancy.