What is endometriosis?
Endometriosis is when tissue is found outside the uterus that appears similar to the lining of the uterus (endometrium). Endometriosis may grow outside of your uterus, ovaries, and tubes and even on your bladder or intestines. This tissue can irritate the structures it touches, causing pain and adhesions (scar tissue) on these organs.
How can I tell if I have endometriosis?
Many women with endometriosis have pelvic or abdominal pain, particularly with menstrual bleeding or sex. Some women have no symptoms. Endometriosis can make it difficult to become pregnant. In fact, 30% to 50% of infertile women have endometriosis. Sometimes, endometriosis can grow inside your ovary and form a cyst (endometrioma). This usually can be seen on ultrasound, unlike other endometriotic tissue. The only way to tell for certain if you have endometriosis is through a surgical procedure called laparoscopy.
How endometriosis interferes with fertility
Endometriosis may affect fertility in several ways.
Endometriosis can cause scar tissue, cysts, and adhesions to form in and around your reproductive organs. This tissue can interfere with the conception process.
When a mature egg is released from one of your ovaries, it’s supposed to travel through a fallopian tube and into your uterus. Scar tissue and ovarian cysts can make this journey impossible by:
- preventing the release of an egg
- preventing the fallopian tubes from picking up an egg
- blocking the fallopian tubes
Adhesions can also cause your ovaries to stick to your uterus, making it harder for the fallopian tube and ovary to connect. Scar tissue and lesions may also alter the shape of your uterine cavity. This may make it harder for an embryo (fertilised egg) to implant itself in your uterus.
Endometriosis causes inflammation in and around the reproductive organs. This inflammatory environment may be less hospitable to conception. It can impact egg quality and maturation. It can also impact the fertilisation and implantation process.
Inflammation also affects hormone production by reducing the ovaries’ ability to produce ample amounts of estrogen and progesterone.
Scar tissue in and around the ovaries can also alter blood flow, reducing the ovaries’ oxygen supply and diminishing egg quality and maturation.
Pain during sex
Endometriosis can cause severe pain during and after penetrative vaginal sex. This can make it difficult to have sex during your fertile window. The pressures of baby-making sex can be challenging at best for couples trying to conceive. When you add physical pain to the equation, it can be even tougher.
I have endometriosis. Should I worry?
If you are diagnosed with endometriosis while trying to build a family, doctors will tell you not to panic. Here are reasons why there is still hope for pregnancy amidst this reproductive problem.
Endometriosis does not mean you cannot have children.
A greater proportion of women with endometriosis indeed have difficulty getting pregnant. But just because you have endometriosis doesn’t automatically mean you have infertility. Endometriosis happens when the cells lining the uterus start to grow in places they shouldn’t, such as the ovaries or fallopian tubes. These growths can cause problems like blocking your fallopian tubes or forming scar tissue, making it harder to get pregnant.
But the problem varies for each woman. Some people might have extensive endometriosis; others might have just a few “spots” where growth occurs. Endometriosis can prevent a woman from getting pregnant, but it certainly doesn’t have to.
Trying to get pregnant on your own when you have endometriosis is not harmful.
Don’t assume you need to see a fertility specialist immediately when you want to get pregnant. Suppose a woman with endometriosis is not pregnant after six or seven months of trying on her own. In that case, doctors may ask her to come for a fertility consult to see if the endometriosis contributes to her difficulty getting pregnant.
You may find it takes a little longer than usual, but with patience and perseverance, you’ll be holding your bundle of joy before you know it.
Depending on your specific case, there are many potential treatments.
If you have endometriosis and are struggling with fertility, the first step is to be evaluated by a fertility specialist to see if the fallopian tubes are open. This is because there are two main ways that endometriosis can impact a woman’s fertility: macroscopic and microscopic disease.
Some women with macroscopic disease may have lesions and scar tissue that can sometimes block the fallopian tubes, making it difficult for the egg to make its way into the uterus. On the other hand, many women with endometriosis have completely open tubes—but still struggle with fertility. This is microscopic endometriosis, and the reasons for the difficulty with fertility are less well understood.
An evaluation with a fertility specialist can help physicians determine the extent to which your endometriosis contributes to infertility and guide treatment accordingly. Depending on the extent of the disease, treatment options for infertility might range from oral medications to more advanced treatments, like intrauterine insemination, in vitro fertilisation, or laparoscopic surgery.
What should a person with endometriosis do if they struggle to get pregnant?
If you suspect endometriosis and are struggling to get pregnant, you should make an appointment with your reproductive endocrinologist or gynecologist specialising in endometriosis and reproductive surgery. They will review your health history and perform a physical exam. Laparoscopy is sometimes done to diagnose endometriosis, especially if you have many symptoms. This uses a thin tube with a lens and a light at the end. It’s inserted into an incision in the abdominal wall to help the physician see the pelvic area. Your healthcare provider can often find the misplaced tissue’s locations, extent, and size.
Sometimes, endometriosis is suspected based on findings from a pelvic ultrasound or other imaging studies. There are also times when endometriosis is suspected based only on symptoms. You also may be referred to a fertility specialist to discuss other treatment options for endometriosis that will preserve and improve fertility.
How can we help you?
Super Health Chatswood Medical Centre offers to provide postsurgical rehabilitation and fertility support. Physiotherapy isn’t just about helping improve mobility. It also involves physiotherapeutic care for women who are struggling to become pregnant. So before signing up for IVF treatment, why not try a spot of physical therapy first? Our physiotherapist can help women suffering from conditions such as:
• Gynaecological surgery
• Painful sex
• Pelvic Pain
Suffering from infertility can be extremely stressful, so we do all we can to help reduce that stress.
If you’re looking for the best physio Chatswood has to offer, there’s only one name to remember, and that’s Super Health Chatswood Medical Centre. Why not call us today at (02) 9884 9300 to schedule an appointment.
Endometriosis can affect fertility in several ways. Scar tissue and adhesions can alter the anatomy of the pelvic area, causing blockages and other issues. Inflammation can impact egg quality and maturation. And the fertilisation and implantation process can be affected.
Several treatment options are available for people with endometriosis who are experiencing difficulty becoming pregnant. Talk with a healthcare professional about your symptoms and fertility goals to determine your best course of action.