Endometriosis and Fertility
Endometriosis is a condition in which women have painful periods. In this condition the tissue similar to inner lining of the uterus or the endometrium grows outside its normal place. It might grow in places like inside the uterine muscle or myometrium, on the ovaries, fallopian tubes or the tissues lining the pelvic cavity.
Endometrium or the inner lining of the uterus grows every month starting from the completion of menses and then sheds during the next menstrual cycle. The tissue which grows outside the uterus also follows the same pattern. But since there is no way to exit the body, the blood gets trapped and collected inside these tissues.
This leads to formation of cysts inside the ovaries which contain chocolate coloured endometriotic fluid. Hence they are called chocolate cysts of ovaries. If this fluid gets collected inside the uterine muscle, it leads to formation of adenomyomas.
When it grows over the tissues lining the pelvic cavity, it leads to formation of fibrous bands called adhesions inside the pelvis. These adhesions cause pelvic tissues and organs to stick to each other. This leads to symptoms like severe pain which is more during menses.
Comman symptoms of endometriosis are
- Painful Periods: Cramping may begin before and extend several days into a menstrual period.
- Pain with intercourse
- Chronic pelvic pain
- Painful bowel movements
- Painful urination
- Heavy menstrual bleeding
Women with endometriosis are at high risk of facing problems of infertility.Endometriosis can lead to damage of normal ovarian tissue leading to low ovarian reserve.Hence patients having endometriosis should take the decision of IVF early.
Pelvic adhesions or fibrous bands around fallopian tubes make it difficult for the tube to pickup the egg.
Endometriotic fluid is toxic for the eggs and the embryo which can cause problem in embryo implantation.
Women with endometriosis should not delay having children because the condition may worsen with time.
Treatment of endometriosis
- Young women
- Treatment of pain using painkillers
- Hormones are sometimes effective in reducing or eliminating the pain of endometriosis
- Women interested in child-bearing
- The couple should be counseled to undergo basic investigations and go for treatment options as early as possible
- Women with severe endometriosis having adhesions might need to undergo laparoscopic surgery
- Women with moderate and severe endometriosis with low ovarian reserve are advised to go for IVF
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