Endometriosis

Endometriosis, a cause of female infertility, is a condition in which endometrial tissue, the tissue that lines the inside of the uterus, grows outside the uterus and attaches to other organs in the abdominal cavity, such as the ovaries and fallopian tubes. Endometriosis is a progressive disease that tends to get worse over time and can reoccur after treatment. Symptoms include painful menstrual periods, abnormal menstrual bleeding and pain during or after sexual intercourse.

A laparoscopy, an outpatient surgical procedure, is necessary to confirm a diagnosis of endometriosis after a medical history review and pelvic exam. After the initial diagnosis, your physician will classify your condition as stage 1 (minimal), stage 2 (mild), stage 3 (moderate) or stage 4 (extensive) based on the amount of scarring and diseased tissue found.

Treatment:

Some people believe that endometriosis, and not ovulatory dysfunction, is the single most frequent cause of infertility. Unfortunately, the diagnosis of endometriosis is not very reliable since it requires surgery (laparoscopy) and, even then, microscopic disease may be overlooked. Endometriosis can affect the ovaries (and probably egg quality), can increase the risk of miscarriages, and may cause infertility. For treatment of the infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present. If this is not effective after about 6 cycles (maximum), then in vitro fertilization should be considered.

Infertility in women with severe endometriosis is often resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, insemination would probably be futile. These women will often require in vitro fertilization in order to conceive.

Endometriosis Treatment Value:

Our physicians have extensive experience in the treatment of endometriosis. Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the severity of the disease and its location in the pelvis, the age of the woman, length of infertility, and the presence of pain or other symptoms.

Next Steps:

For more information on Endometriosis your next step should be:

• Send us an Infertility Consultation