Why does endometriosis cause infertility

The endometrium is a tissue which lines the uterine cavity. Endometriosis is a disease in which this tissue has spread further than it should, such as to the ovaries, or even elsewhere in the abdominal cavity. Endometriosis can be a cause of pain for some women, and in many, it is the leading cause of infertility. An estimated 5-10% of women in the United States have some form of endometriosis. It is also estimated that around 40% of the women who were deemed infertile, were also diagnosed with endometriosis.

The only positive way to be sure of whether or not a woman has endometriosis is a small surgical procedure called a laparoscopy. This procedure allows doctors to look inside the adbominal cavity using a small scope. Most women who have been diagnosed with endometriosis, no matter the stage, cite having severe lower abdominal and pelvic pain. Although mild endometriosis has been associated with infertility in women, there are many fertile women who also have mild endometriosis. There really has been no pattern established between mild endometriosis and infertility, but it is believed that infertility and delayed pregnancies are what cause women to develop endometriosis, rather than endometriosis being the sole cause of infertility. Because of this discovery, some doctors are saying that infertility associated with a mild form of endometriosis is an unexplained infertility.

In the case of severe endometriosis, pelvic scarring and distortion may occur. In this cause, the fallopian tubes could be damaged or blocked entirely, and the ovaries could contain cysts. Because of these anatomical distortions, women with cases of severe endometriosis are more likely to be infertile than those who have been diagnosed with mild endometriosis. In many extreme forms of endometriosis, the eggs in the ovaries could be damaged, which results in a depleted ovarian reserve and reduced egg quality.
To determine if endometriosis and infertility go hand in hand, treatment for the condition must be personalized for every woman. There are really no easy answers an dmany treatment and decisions depend on factors such as the degree of the disease and how it affects the pelvis, as well as the age of the woman and the presence of symptoms. Mild endometriosis can be corrected with surgical treatment, but there is no significant evidence that such a treatment will improve pregnancy rates for infertile women. For women with endometriosis who want to become pregnant, in vitro fertilization should be considered.

Unfortunately for women who have been diagnosed with this disorder, there is often little that can be done to address the infertility which it causes. Endometriosis is often resistant to treament, as well as intrauterine insemination. In women in which the pelvic anatomy is completely disfigured, treatments like this are usually hopeless. The only available option for these women is undergoing in vitro fertilization, but the good news here is that it is often successful in women under 40 who are still producing eggs. Because of this, many doctors are recommending this method for couples who wish to deal with their infertility caused by endometriosis.