Endometriosis and its affects on your Fertility

Endometriosis is a medical condition where the tissue that lines the inside of your uterus (also called the endometrium) spreads to other areas of your body, usually to your pelvic organs. Endometrial tissue found on your fallopian tubes or ovaries can lead to scarring, adhesions, and blockages within your pelvis.

Endometriosis is estimated to affect about 7 percent of women of childbearing age. However, endometriosis is found in approximately one-third of infertile women. Therefore, endometriosis is a major factor when considering the causes of female fertility problems.

The main symptom of endometriosis is pelvic pain. The pain and cramping occurs most often just before and during your menstrual cycle. The pain sometimes occurs during sexual intercourse, urination, or bowel movements. The amount of pain does not always tell you the severity of your condition. For example, some women with slight pain may have a severe case of endometriosis. However, those with signifi cant pain may actually have mild endometriosis. And some women with endometriosis have absolutely no symptoms. In many situations, endometriosis is only diagnosed as part of an infertility evaluation, after a woman has been unable to conceive on her own.

• What Does Endometriosis Do? How Does It Affect My Fertility?

It’s important to understand exactly what endometriosis does and how it affects your fertility. Under normal circumstances, the only place that endometrial tissue can be found is the inside of your uterus. However, if you have endometriosis, that means endometrial tissue is also growing somewhere else within your body. It most often appears in various places within your pelvis, such as the ovaries, fallopian tubes, outside surface of the uterus, space behind the uterus, bowel and rectum, and bladder. It may occasionally be found in more distant parts of the body, though this is rare.

Wherever endometrial tissue is found within your body, it basically still acts the same as that found within your uterus. Endometrial tissue is very responsive to changes in your hormones. So during your menstrual period, the tissue breaks down and bleeds, just the same way that the lining of your uterus does. This bleeding can cause pain, especially just before and during your period. The breakdown and bleeding of the endometrial tissue located throughout your pelvic organs can cause scar tissue and adhesions.

Oftentimes the scarring and adhesions cause various pelvic organs to bind together and distort the normal pelvic anatomy. This could cause the ovaries to become anchored in an awkward position so that the egg cannot properly reach the opening of the fallopian tube. In another case, the scarring and adhesions may block the fallopian tubes so that an egg cannot pass from the ovary into the uterus. Endometrial tissue may grow within an ovary and cause a cyst, usually called a chocolate cyst or endometrioma. The affected ovary and cyst may not be able to ovulate and function normally. Sometimes an ovary cannot properly release an egg because the egg is trapped within the follicle by scarring on the ovary’s surface.

Endometriosis may also reduce fertility in other ways besides the scarring and adhesions already discussed. For example, toxic substances may be released by the endometrial tissue scattered about your pelvis. In this case, even if the egg is successfully released from the ovary and passes to the fallopian tube, the toxins might diminish the egg’s ability to become fertilized. In addition, endometriosis can lessen fertility by giving off an immune response. That means that the endometrial tissue outside the uterus sends a signal to release destructive cells within the pelvis that can destroy eggs, sperm, and even an embryo