Monday, December 29, 2008

Endometriosis and Infertility

I found this information on

Endometriosis is one of the most common causes of pelvic pain and infertility in women.
Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body. Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum.

The most common symptom is pelvic pain. The pain often correlates to the menstrual cycle, but a woman with endometriosis may also experience pain that doesn’t correlate to her cycle. For many women, the pain of endometriosis is so severe and debilitating that it impacts their lives in significant ways.
Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a "frozen pelvis."
It is estimated that 30-40% of women with endometriosis may not be able to have children.

The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, however a woman with endometriosis may also experience pain at other times during her monthly cycle.
For many women, but not everyone, the pain of endometriosis can unfortunately be so severe and debilitating that it impacts on her life significant ways.
Pain may be felt: before/during/after menstruation, during ovulation, in the bowel during menstruation, when passing urine, during or after sexual intercourse, in the lower back region

Other symptoms may include:
diarrhoea or constipation (in particular in connection with menstruation), abdominal bloating (again, in connection with menstruation), heavy or irregular bleeding fatigue.

The other well known symptom associated with endometriosis is infertility. It is estimated that 30-40% of women with endometriosis are subfertile.

Diagnosing endometriosis

There is no simple test that can be used to diagnose endometriosis. In fact, the only reliable way to definitively diagnose endometriosis is by performing a laparoscopy and to take a biopsy of the tissue. This is what is known as "the golden standard".
However, this is an expensive, invasive proceduce. Furthermore, if the surgeon is not a specialist in endometriosis s/he may not recognise the disease, which can result in a "negative" diagnosis.
There are other tests, which the gynaecologist may perform. These include ultrasound, MRI scans, and gynaecological examinations. None of these can definitively confirm endometriosis (though they can be suggestive of the disease), nor can they definitively dismiss the presence of endometriotic lesions/cysts.
The fact that there is no non-invasive, definitive diagnostic method for endometriosis is as frustrating for clinicians as it is for women with the disease.

Endometriosis and Infertility
by Ros Wood

Overall, women with endometriosis find it harder to become pregnant than women in general. However, little research has been carried out into this topic, so it is not possible to give you an accurate indication of how much endometriosis will affect your fertility.
Nevertheless, studies indicate that women with minimal–mild endometriosis take longer to conceive (become pregnant) and are less likely to conceive than women in general.

It also appears that the more severe the woman’s endometriosis, the more likely it is that she will have difficulty becoming pregnant. Thus, women with moderate–severe endometriosis tend to have more difficulty conceiving than women with minimal–mild endometriosis.

However, it is important to remember that having endometriosis does not automatically mean that you will never have children. Rather, it means that you may have more problems.
Many women with endometriosis have children without difficulty, and many others become pregnant eventually — though it may take time, and may require the help of surgery or assisted reproductive technologies or both.

1 comment:

Michelle Lasure said...

I had endo issues since I was 16 (I'm 36 now) and had to go through 7 doctors before I was diagnosed. I had 5 surgeries before I had a total hysterectomy 5 years ago, and now I'm pain-free. I had endo on my lungs, diaphragm, cul-de-sac, and ovaries. They categorized as stage 4, "frozen pelvis". I know my case is more extreme than many, but I wanted to let others out there reading this blog what it may take to be diagnosed. Endo is elusive, and is not easily diagnosed. My advice to any of you out there going through pelvic pain issues is BE YOUR OWN ADVOCATE. Don't let anyone tell you you're imagining it, that "you just need to have kids" (I love that one!), or that it's all in your head. YOU know your body and don't let anyone minimize your pain. If one doctor doesn't give you the answers you want, find another one! There are doctors out there who know their stuff when it comes to endo. Remember, YOU are paying THEM...make them work FOR you!


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