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endometriosis and infertility

Endometriosis and Infertility
IHR provides effective treatment programs for endometriosis related infertility.

Endometriosis is a condition affecting millions of menstruating women 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. Although the cause of endometriosis is unclear, treatment and management of the disease can be effective. The IHR experts work closely with couples undergoing the many different types of assisted fertility treatments available. We are renowned for our specialized knowledge and high infertility success rates even in difficult cases. IHR's expertise in endometriosis and infertility lies in our willingness and ability to individualize our approach to best suit each and every one of our patients. If you have any questions as you review the material on endometriosis and infertility, please contact us for a FREE Endometriosis and Infertility E-Mail Consultation.

About 30 to 40 percent of women with endometriosis have problems conceiving – in fact, infertility becomes more likely as the disease progresses. There are a number of ways which endometriosis can affect fertility: scarring or adhesions in the pelvis, ovaries and fallopian tubes may not be in the right position, inhibiting the transfer of eggs to the fallopian tubes, damage or blockage to the inside of the fallopian tube, impeding the journey of the egg down the fallopian tube to the uterus., fallopian tubes and ovaries may adhere to the lining of the pelvis or to each other, restricting their movement, impaired implantation of an embryo in the uterus, endocrine and ovulatory abnormalities, such as over-production of prostaglandins, hormones that play an important role in the fertilization and implantation of the embryo, altered hormonal and cell function, bodies natural inflammatory response to this “misplaced tissue” can result in the production of factors that inhibit fertility.

The symptoms of endometriosis can include pain, infertility, and abnormal menstrual bleeding. Pain might occur at different points in the menstrual cycle and can be severe. However, some women with even severe endometriosis may not experience discomfort. Regardless, accurate diagnosis of endometriosis is important. Even mild cases of endometriosis can affect fertility. Endometriosis may cause infertility due to organ damage, embryo implantation problems, increased white blood cells within the abdominal area, and stress on the immune system. While pelvic or ultrasound exams may suggest endometriosis, the only way to definitively diagnosis the disease is with direct inspection via laparoscopy. A laparoscope is a long, thin, lighted, flexible, telescope-like instrument, inserted through a small surgical incision just below the navel. The surgeon can then view and treat, if necessary, endometriosis or other pelvic conditions. Microlaparoscopy is now available where a telescope the diameter of the tip of a ball point pen is used.

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.

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.

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. Often the first choice of treatment associated with mild to moderate endometriosis is controlled ovarian hyperstimulation with intrauterine insemination, which 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.

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. Our physicians have extensive experience in the treatment of endometriosis for infertility.

IHR has treatments for a variety of conditions, including ovulatory dysfunctions, endometriosis, immunological infertility and many others. Perhaps less known is our work with individuals and couples who are considering assisted reproduction, but who are uncertain of their next step. We encourage anyone, before they make a decision, to consult with us. Currently, we are offering a FREE Endometriosis and Infertility E-Mail Consultation.