Endometriosis and Fertility

Endometriosis is a gynecologic condition that affects approximately one in ten women of reproductive age and for some of these women, it can lead to infertility.  According to some studies, approximately 30-50 percent of women with endometriosis have impaired fertility.

Endometriosis occurs when the tissue that makes up the inner lining of the uterus implants in other areas of the pelvis, abdomen, or other locations in the body. When that tissue type is found outside of the uterus, it can cause severely painful periods, pain with sexual intercourse, and various gastrointestinal symptoms.  Nobody really knows why endometriosis occurs, but one leading theory is retrograde menstruation. The thought is that when a woman has her period, blood flows backwards though fallopian tubes and out into the pelvis instead of out through the vagina.  Other possible theories of what causes endometriosis include genetics, the immune system, and possible environmental factors.

When endometriosis is present, it can affect a woman’s fertility in multiple different ways.  Endometriosis can cause severe scarring and inflammation in the pelvis.  For some women, this scarring can affect the reproductive organs, including the fallopian tubes.  Endometriosis can cause scarring in and around the fallopian tubes, making them non-functional.  Some women with endometriosis will have endometriomas, also known as chocolate cysts. These are blood-filled cysts in the ovaries that can cause inflammation and destroy healthy eggs in the ovaries.  Lastly, the severe inflammation caused by endometriosis may make the whole reproductive system less inviting for embryo implantation.

Of course not all women with endometriosis will have difficulty with fertility.  Many women with this condition are able to easily conceive, especially if they have mild disease and are young. If you know you have endometriosis or think you may have this condition though, you may want to speak with your physician about ways you can protect your future fertility. Since we can’t predict which women with endometriosis will have fertility issues in the future, some women with this disease will opt for egg or embryo freezing.  This gives them options in case they become one of the women with impaired fertility in the future.

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