Endometriosis Impact on Fertility: Details on Causes, Options for Treatment, and Other Relevant Information
Endometriosis is a condition that affects millions of people worldwide, particularly women of reproductive age. It occurs when tissue similar to the uterine lining grows outside the uterus, potentially causing a range of health issues, including difficulties with fertility.
Infertility is one of the most significant challenges associated with endometriosis. The rogue tissue can block fallopian tubes, grow into the ovaries, and damage the reproductive organs, disrupting normal reproductive function. This can lead to structural distortion of reproductive organs and reduced oocyte (egg) quality.
However, it's important to note that endometriosis does not necessarily cause infertility. It can, however, make it more challenging for a person to get pregnant. About 30-40% of people with infertility also have endometriosis.
The severity of endometriosis varies, with three main types: superficial peritoneal, endometriomas, and deeply infiltrating. Superficial peritoneal endometriosis is the least severe form and can still make conceiving difficult. Endometriomas are cysts that grow on the surface or inside the ovaries and can greatly impact a person's fertility. Deeply infiltrating endometriosis is the most severe form and can grow on organs near the uterus, such as the vagina, bladder, and bowel.
Doctors use the endometriosis fertility index (EFI) to evaluate a person's condition and predict their likelihood of getting pregnant without medical intervention. The EFI considers factors such as age, endometriosis stage, least function score, length of infertility, medical history, prior pregnancies, and age. People with scores of 5 or higher might be able to try conceiving naturally for 24 months before medical intervention, while those with scores of 4 or lower should be referred for artificial reproductive treatments more quickly.
Treatment options for individuals with endometriosis struggling to conceive include a comprehensive fertility evaluation, hormone testing, imaging, ovarian reserve assessment, and sometimes diagnostic laparoscopy. Based on the severity of the condition and fertility goals, treatments may involve surgical removal of endometriotic lesions to improve anatomy and reduce inflammation, hormone therapy to optimize reproductive hormones, and assisted reproductive technologies (ART) like intrauterine insemination (IUI) or in vitro fertilization (IVF).
In the earlier stages of endometriosis, a doctor may recommend a laparoscopy to assess and remove lesions, but this surgery can decrease the number of eggs a person has. In the later stages, a doctor is likely to recommend IVF as a treatment option. IVF requires a person to inject fertility medication, harvest eggs, fertilize them with sperm, and implant embryos into the uterus.
Support groups such as the Endometriosis Association (EA), Endometriosis Foundation of America, The InterNational Council on Infertility Information Dissemination (INCIID), and RESOLVE can provide resources and support for those dealing with endometriosis and infertility.
While endometriosis can impair fertility, several effective treatment options ranging from surgery to ART are available and should be tailored individually based on severity and reproductive goals. For people aged 35 or older, doctors may recommend a combination of the drug clomiphene with intrauterine insemination (IUI) instead of surgery.
In conclusion, endometriosis can negatively impact fertility, but with proper diagnosis and treatment, many people can overcome these challenges and achieve their dreams of starting a family.
Women with endometriosis may experience issues with fertility, as the rogue tissue can block fallopian tubes and damage reproductive organs, potentially leading to structural distortion and reduced oocyte quality. Science and health-and-wellness professionals have developed the endometriosis fertility index (EFI) to predict a person's likelihood of getting pregnant without medical intervention.
Individuals struggling with endometriosis-related infertility can seek help from various treatment options, including surgical removal of endometriotic lesions, hormone therapy, assisted reproductive technologies (ART) like IUI or IVF, and a comprehensive fertility evaluation. Support groups such as the Endometriosis Association, Endometriosis Foundation of America, and others offer resources and support for those dealing with this condition.
While endometriosis can create challenges for female fertility, effective treatment options are available, tailored based on the severity and reproductive goals of each individual. In some cases, a combination of clomiphene and intrauterine insemination (IUI) may be recommended over surgery for those aged 35 or older.
Despite the potential impact on fertility, proper diagnosis and treatment can help many people with endometriosis overcome these challenges and achieve their dreams of starting a family.
