Endometriosis and Adenomyosis

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Endometriosis is a condition in which there is the presence of functioning endometrium in sites other than uterine lining (inside the uterus). It is possible for these growths to damage surrounding reproductive organs, affecting fertility as the condition progresses.

Endometriosis and infertility: what you need to know

Endometriosis can occur at any site. It can be present inside the abdomen or extra-abdominal sites. Common sites are:

Ovaries
Fallopian tubes
Pouch of Doughlas
Pelvic lymph nodes
Peritoneum
Sigmoid colon
Appendix
Abdominal scar.

Rare sites: brain, lungs, kidney, ureter etc. Most common symptom in endometriosis is lower abdominal pain radiating to the thighs and back. It can present before/during menstruation, before / during ovulation, before/ during sexual intercourse, while passing stools, while passing urine etc.

Is endometriosis a cause of infertility?

Endometriosis is a progressive condition, meaning it can gradually worsen over time. As endometriosis patches grow in the pelvic and abdominal areas, they can block the reproductive organs. As a result, sperm have a harder time reaching the egg. It is also possible for these growths to damage the reproductive organs, preventing them from functioning properly. Endometriosis can also affect fertility by-

Preventing the implanting of an embryo
Scarring of the fallopian tubes
Affecting the growth of eggs
Inducing hormonal imbalances
Chronic pelvic inflammation

Types of endometriosis and fertility

There are three types of endometriosis: superficial peritoneal, endometriomas, and deep infiltrating. A person’s body is classified according to the location of the endometriosis patches. A person can have one or multiple types. Additionally, medical professionals divide endometriosis into stages. They range from I-IV, with stage I being the least severe and stage IV the most severe.

Superficial peritoneal

The peritoneum is a thin film lining the abdomen. When a person has a peritoneal lesion, they may have growths or cysts in the peritoneum. Doctors usually class superficial peritoneal lesions as stage I or II endometriosis. Despite superficial peritoneal lesion being the least severe form of endometriosis, some people may find conceiving difficult.

Endometriomas

Endometriomas are cysts that grow on the surface of or inside the ovaries. They are dark, fluid-filled sacs that doctors sometimes refer to as chocolate cysts. When a person has endometrioma, they usually have stage III or IV endometriosis. Endometriomas can greatly impact a person’s fertility due to their damaging effect on ovarian tissue, which may lead to ovulation issues.

Deeply infiltrating

In deeply infiltrating endometriosis, endometrial-like tissue grows on organs near the uterus, such as the vagina, bladder, and bowel. It is the most severe form of the condition. Doctors usually classify deeply infiltrating endometriosis as stage IV because a person has growths or lesions that extend 5mm below Trusted Source the peritoneum.

In addition to endometriomas, a person with stage IV endometriosis may have extensive scarring in the ovaries, uterus, and rectum.
If a person has already undergone previous cyst removal surgeries, they may have also lost a significant number of eggs.
It is important to note that while a person may no longer be able to conceive naturally at this stage, they may become pregnant with IVF treatment.

Support for endometriosis and infertility

Endometriosis is a painful, progressive condition that can be difficult to cope with. People struggling to get pregnant with the condition may feel isolated and discouraged, especially if they have been trying for a number of years without success.