ALL ABOUT ENDOMETRIOSIS AND INFERTILITY

What is endometriosis?

Endometriosis is a chronic inflammatory condition which affects approximately 8-10% of women in the general population and approximately 40% of infertile women. This enigmatic disease is associated with pain during menstrual periods, intercourse, defecation, urination and ovulation as well as long standing pelvic pain and infertility.

The endometrium is the lining of the womb. It is programmed naturally to grow and shed every month and that is what happens when you have your menstrual periods. But, if endometrial tissue starts growing outside the womb, in the ovaries for example, there is no way that the tissue can be shed, so it remains trapped and may cause scarring.

What causes endometriosis?

There are many putative theories, but no clear answers on what actually causes endometriosis. Theory of retrograde menstruation, the lining of uterus moving up the tube to be deposited in the pelvis instead of flowing out through the vagina is one such theory.While there is still no known cause of endometriosis, it is very likely that certain genes may predispose women to develop endometriosis, so affected women may have a similarfamily history in their mother and/or sister(s).

How does Endometriosis affect your Fertility?

All stages of endometriosis can potentially contribute to infertility, probably by one or the other mechanisms.Where endometriosis is present in the ovaries, it can cause ovulatory abnormalities by affecting both quality and quantity of eggs causing fall in ovarian reserve. The eggs don’t get a healthy environment to grow as follicular fluid in such cases is also abnormal. The free radicals and collected blood cause local inflammatory reaction and produce poor quality eggs.

In severe cases, endometriosis can also cause tubal damage and make it difficult for sperm to travel through the fallopian tubes, and so preventing the egg and sperm from fertilisation.

Endometriosis may also cause a decrease in endometrial receptivity.

How is Endometriosis Diagnosed?

1. Many a times endometriosis goes unnoticed.
2. You can use an ultrasound scan to identify endometriosis, particularly if it causes cysts in the ovaries, also called chocolate cysts.
3. The best way is doing a diagnostic laparoscopy which involves a camera inserted through the abdomen which allows us to look around the pelvis to identify endometrial tissue.
4. An AMH test can indicate your ovarian reserve (how many eggs are left), though this does not tell the quality of the eggs.

Symptoms of Endometriosis

1. Typical complaints of those with endometriosis include:
2. painful periods
3. pain during intercourse
4. chronic pelvic discomfort or pain
5. chronic nagging lower back pain
6. pain during defecation
7. pain when passing urine
8. premenstrual symptoms including pain and pelvic congestion.
9. Decreased fertility may also be the presenting symptom in some women with endometriosis.

Fertility Options with Endometriosis.

Once a couple realises that there is a problem or delay in achieving fertility, it is always better to start treatment at the earliest as this is a progressive condition.

There are three main fertility options, depending on the type and severity of your endometriosis. These are: Ovulation Induction with IUI, laparoscopic surgery, and IVF. Vasundhara hospital and Fertility Research Centre is the Best IVF Hospital in Jaipur providing all the high end treatments from laparoscopy to IUI and IVF-ICSI with highest success rates.

1. Ovulation Induction with IUI– Ovulation is stimulated using medicines. Husband sperms are injected inside wife’s uterus using a fine catheter. Although, it doesn’t overcome the issue of tubal damage, so you have to be sure that this is not the cause. This is specially beneficial in early endometriosis.
2. Laparoscopy with adhesiolysis: Treatment by laparoscopy increases pregnancy rates as we can break the adhesions that prevent egg collection by tubes. Also, surgical removal of endometriosis lesions has been successful in almost 50 percent of cases, depending on the severity of the disease.
3. IVF (In Vitro Fertilisation)– If endometriosis is present, without endometrioma (chocolate cyst), IVF has a high chance of success. IVF works very well for most people with endometriosis, because it overcomes the tubal difficulty and also takes care of fertilisation problems. However, if ovarian reserve is poor or if there are also endometrioma cysts present, the chances of success are lower even with IVF.

Best Approach to Endometriosis?

1. It is critical that you speak with a fertility specialist to discuss the pros and cons of the various treatment methods and find out the best possible option according to your condition.
2. Don’t waste time as it may progress. Even if trying naturally, it is better to be under monitoring.
3. IVF-ICSI is the most successful treatment of the condition; however it is not the first line of treatment in all the cases.

In most cases, there is a successful outcome. Endometriosis does not mean that you cannot conceive, and in some cases, people may even conceive naturally with endometriosis. However, if you find that it is preventing, then get help sooner rather than later.Trying to get pregnant and deliver a healthy baby when you have endometriosis creates special challenges and requires careful individualized planning with your fertility doctor. To address infertility, your treatment plan will consider your age, duration of infertility, pelvic pain, and the stage of your endometriosis along with ovarian reserve and tubal status to maximize your chance of success.In case, you are wondering from where to get the treatment then you can visit our IVF Centre in Jaipur.