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Endometriosis is a common but treatable condition.
It is seen in 6-10% of women worldwide and in 30-40% of infertile patients.
If diagnosed and treated early, the impact of endometriosis on fertility success can be prevented.
What is the Relationship Between Endometriosis and Pain?
The symptoms of endometriosis vary widely. Some women are unaware that they have the condition. A woman diagnosed with “unexplained infertility” may actually have endometriosis. Therefore, it is crucial for patients to receive the correct diagnosis.
In other cases, severe pain is the key indicator, and it can range from moderate to severe.
What is Endometriosis?
The lining of the uterus is called the “Endometrium.” In endometriosis, the normal uterine lining grows in an abnormal location.
Normally, the uterine lining is shed during menstruation and expelled through the cervix. In endometriosis, however, this lining moves in a different direction, down towards the fallopian tubes, and surrounds the ovaries and nearby structures.
Like the normal uterine lining, these cells grow and “bleed” during menstruation, causing local inflammation and scar tissue. Over time, the areas of endometriosis may cause pain and infection.
If left untreated, the uterine lining can grow and block the fallopian tubes and ovaries, which can prevent pregnancy.
What is the Relationship Between Endometriosis and Infertility?
Due to its effect on reproductive health, many patients with endometriosis are diagnosed during fertility tests.
Endometriosis:
- Can cause scarring or adhesions in the pelvis, including the ovaries and fallopian tubes.
- Can cause damage or blockage in the fallopian tubes, preventing the egg from reaching the uterus.
- Can cause endometriotic spots in the ovaries. These types of cysts are called chocolate cysts/endometriomas.
What Are the Symptoms of Endometriosis? How is it Diagnosed?
Some patients may have no symptoms related to endometriosis.
In the absence of symptoms, most women are actually diagnosed with “unexplained infertility” despite having endometriosis.
It is crucial to obtain a correct diagnosis of endometriosis. If you experience the following symptoms, we strongly recommend consulting a fertility specialist.
Symptoms may include:
- Infertility
- Severe menstrual cramps / painful periods
- Pain after sexual intercourse
- Painful bowel movements
- Back pain
- Abnormal menstrual bleeding
How Do We Diagnose Endometriosis?
Endometriosis cannot be diagnosed solely based on symptoms. Your doctor must conduct a comprehensive examination and tests to confirm the diagnosis.
It is also important for your doctor to gather information about your medical history. Depending on the severity of your endometriosis, your doctor may recommend one or more of the following tests:
- Pelvic exam to assess pelvic tenderness or endometriotic spots
- Pelvic ultrasound to show endometriotic lesions
- Laparoscopy: This is a surgical procedure where the inside of the abdomen is viewed using a camera system and is the only definitive way to confirm the presence of endometriosis.
To determine which treatment is appropriate for endometriosis, the amount of damaged and diseased tissue detected during laparoscopy classifies your condition as Minimal (stage 1), Mild (stage 2), Moderate (stage 3), or Severe (stage 4).
Your doctor will create a personalized treatment plan tailored to relieve your symptoms and maximize your chances of a successful pregnancy.
What Are the Treatments for Endometriosis?
Our goal is to provide you with the most appropriate treatment.
We aim to suppress endometriosis, control its progression, and target the symptoms without affecting your fertility.
Treatment Options
Your doctor can treat endometriosis surgically, through IVF, or using both methods.
Successful treatment options include:
IVF
When endometriosis causes infertility, IVF is often the first recommended treatment option.
Laparoscopy
Severe pain can be an indicator of the growth of endometrial tissue outside its normal location. One of the most accurate ways to detect this is through diagnostic laparoscopy, a small surgical procedure. In this way, endometriosis lesions can be easily detected and the diagnosis of endometriosis can be confirmed.
During this procedure, any endometrial tissue present in your ovaries or fallopian tubes can also be removed.
Oral Medications
In most medical approaches, medications that reduce your body’s estrogen production are used to stop the growth of endometriosis. However, while these medications are used, pregnancy is not possible. Therefore, medication treatments are typically postponed until after childbirth, with priority given to fertility treatments.
