Endometriosis

Endometriosis is a common condition that affects up to one in 10 women at some point in their life. Encouragingly, only a third of these women will experience fertility issues. If you’ve been diagnosed with endometriosis and it’s affecting your fertility, we can help you with treatment and next steps.

The good news? Once treated, many of our patients with the condition go on to have a successful pregnancy and a perfectly healthy baby.

What is endometriosis?

Endometriosis occurs when the lining of the uterus - known as the endometrium - starts growing outside the uterus. This causes scar tissue, which can end up destroying tissue and leading to anatomical distortion. If left unchecked, this scar tissue will eventually affect the natural function of the reproductive organs, which can lead to trouble falling pregnant naturally.

If you’re diagnosed with the condition, take heart - there are plenty of treatment options open to you. Your fertility specialist will walk you through your options in detail.

Causes of endometriosis

Frustratingly, the cause of endometriosis isn’t entirely known and can vary between women. However, we do know that if you have a close relative with endometriosis, you’re up to ten times more likely to have it. [1]

According to the not-for-profit organisation Jean Hailes For Women’s Health, certain lifestyle factors may play a role in causing endometriosis.

These include things like:

  • having your first pregnancy at an older age
  • having your first period before the age of 11
  • changes in immune cells
  • low body weight
  • excessive alcohol use

Symptoms of endometriosis

Diagnosing endometriosis

It’s important to note that not all women who experience pain or discomfort during their cycle or during intercourse will have endometriosis. It’s for this reason that diagnosing the condition can be such a challenge.

If your doctor or fertility specialist suspects you have endometriosis, they will often request an expert vaginal ultrasound. This ultrasound can detect deeply-infiltrating endometriosis. If it’s present, your doctor will usually order a laparoscopy (a keyhole surgical procedure) to confirm the diagnosis. First, they may try managing your symptoms medically. But a laparoscopy is the only way to correctly diagnose the condition with certainty.

Laparoscopic surgery allows your doctor to look directly inside your abdomen for signs of endometriosis - including its size, severity and location. Rest assured - you’ll be asleep during the surgery and kept comfortable when you wake up.

Treating endometriosis

Endometriosis and fertility

Endometriosis can cause infertility in different ways.

The female reproductive system - including the ovaries and fallopian tubes - is quite delicate and can be easily compromised. If your endometriosis is severe enough to damage your tubes and ovaries, then this will significantly reduce your ability to fall pregnant.

The fallopian tubes have delicate fimbrial ends like the petals of a flower. During ovulation, these fimbria sweep the surface of the ovaries to pick up the egg. When the fallopian tubes are heavily affected by endometriosis, however, these fimbrial ends can matt together. As a result, they lose the ability to pick up the egg during ovulation.

Endometriosis may also impact your fertility by causing inflammatory changes within your pelvis. These changes create a ‘hostile’ environment for the egg, sperm and embryo. In severe cases, this inflammation can affect the uterus lining (the endometrium). This in turn can affect the implantation of the embryo.

Unfortunately, endometriosis can’t be prevented. But early diagnosis can help stop the disease progressing and worsening your fertility prospects.

Remember, though - not all women diagnosed with endometriosis will experience infertility. Some women will have no trouble conceiving naturally, and will go on to have a successful and uncomplicated pregnancy.

For most women with endometriosis who do experience infertility, we’re here to deliver some good news - there are fertility treatments that can help.

Depending on the severity of the condition, you may require:

  • simple medication
  • laparoscopic surgery to attempt to remove the endometriosis
  • IVF

In many cases, women are able to conceive naturally after surgery. However, if there are other fertility issues present - poor sperm quality, for example - then IVF may be your best option.

If you think you may have endometriosis, we recommend you speak with your fertility specialist as soon as possible. Early diagnosis will help you treat the condition - and move on with your life.

Coping with endometriosis

Western medicine can help you cope with endometriosis, as we’ve outlined above. But it isn’t your only option. Happily, there are some lifestyle and home remedies you can try to help ease the discomfort of your symptoms.

These include:

  • Having a warm bath, or using heating pads or heat bags. The warmth can help relax the pelvic muscles, which in turn can reduce pain and cramping.
  • Keeping moving. Regular exercise can help ease your discomfort—and boost your overall mood.
  • Talking to someone. If dealing with endometriosis has made you feel alone, it might help to join a support group or to talk to someone else with the condition.

Airing your feelings can help ease your burden.

Don’t forget to discuss suitable treatment options with your fertility specialist. The sooner you treat your endometriosis, the sooner you can get on with your life.

1. Symptoms & causes
https://jeanhailes.org.au/heal...
2. https://www.ncbi.nlm.nih.gov/p...

Professor Luk Rombauts

Monash IVF Specialist Luk Rombauts

Professor Rombauts was elected a board member of the World Endometriosis Research Foundation in 2008. He is the vice-president of Fertility Society of Australia and a member of its Scientific Advisory Committee. He was the scientific programme chair of the 10th World Congress of Endometriosis in 2008 and the 14th World Congress on Human Reproduction in 2011.

Professor Rombauts was elected a board member of the World Endometriosis Society in 2008, and became its president elect for 2020-2023 in May 2017.

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