Roughly, 1 in 10 girls and women are affected by endometriosis. Endometriosis is a disease where tissue, similar to the tissue that lines the uterus, can be found throughout the pelvis, bowels, bladder and other organs.
About 4 out of 10 women with Endometriosis will experience some varying degree of infertility. For a couple to achieve pregnancy we need an open fallopian tube, woman ovulating regularly and a normal sperm count.
There is several ways how the endometriosis causes delays in pregnancy:
- In most of the women they have early stages of endometriosis and endometriotic lesions release chemical’s that causes inflammation and are responsible for the pain experienced, however they also create an environment in the pelvis that prevents fertilization of the mature egg.
- Tubal factor – Endometriosis can result in the formation of scar tissue (severe endometriosis or deep infiltrating endometriosis) and adhesions throughout the pelvis. This result in anatomic distortions of the fallopian tubes or ovaries and in some cases blocks the fallopian tubes. They can develop also Hydrosalinx/jematosalpinx as the tube fill with fluid or blood. As a result even the chances of successful IVF are very low without Laparoscopic surgery to address the problem.
- Ovarian reserve – women are born with a fixed number of eggs that are used through the reproductive age which in medical term called ovarian reserve. Endometriosis can cause cyst on the ovaries that are filled with blood called endometriotic cysts. These cysts effects ovarian reserve and medication does not improve ovarian reserve. Proper management by endometriosis is essential.
Endometriosis can only be diagnosed through laparoscopy that allows visualization of the lesions and same time they can be treated at the same time. Ultrasound can detect cysts on the ovaries and in suspected sever endometriosis MRI is essential to identify all the deep infiltrating endometriosis, but need an expert team to diagnose it.
Early diagnosis and treatment of the disease can be beneficial to patients who are concerned about their fertility. Unfortunately the delay in diagnosis due to the lack of expertise can result in delay in identifying the endometriosis until its too late for a women to have a baby. Women experiencing period pains should seek expert advice.
Research had confirmed that Medical treatment of endometriosis is of no benefit and it’s only the removal of all the endometriotic lesion with Laparoscopy increases the chance of pregnancy. Open surgery is of no value as well hence surgery should be performed by an expert Gynecologist in Endometriosis and Laparoscopic surgery. In some cases, we advice IVF treatment, however after 2 failed IVF cycles surgery is advised in line with the European Human Fertilization Authority.
In these women Laparoscopic treatment improves chances of pregnancy either natural pregnancy or IVF depending on the state of the fallopian tubes and ovarian reserve.
Unfortunately endometriosis is a chronic recurrent disease and early diagnosis and expert management is essential in improving and preserving fertility and improving quality of life.