What is Endometriosis?

Endometriosis is a condition, wherein the tissue that forms the lining of the uterus gets implanted and tends to grow outside of the uterine cavity. Unfortunately, the actual cause of it is not known. 

Did you know? The lining of the uterus is known as the endometrium. 

Women suffer from endometriosis when endometrial tissue grows outside the uterus on various sites such as the ovaries, bowel, and the lining of the pelvis.

The hormonal changes of the menstrual cycle tend to affect the misplaced endometrial tissue, owing to which the area becomes inflamed and painful.

This means the tissue will grow, thicken, and break down just like your endometrial lining. Over time, the tissue that has broken down has nowhere to go and becomes trapped in the pelvis region.

This condition can be categorized into one of 4 stages  (I-minimal, II-mild, III-moderate, and IV-severe), depending upon the exact location, extent, and depth of the endometriosis implants as well as the presence and severity of the scar tissue and also the presence and size of endometrial implants in the ovaries. 

This commonly occurring condition can give a tough time to women as it leads to irritation, scar formation, difficulty in conceiving, and painful periods. Thus, it is essential to tackle this condition at the right time by seeking immediate medical attention.

Endometriosis tends to influence fertility in many ways such as distorted anatomy of the pelvis, adhesions, scarring of the fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, and altered egg quality. 

The combination of surgical and medical therapy may be helpful for patients with Endometriosis who wish to conceive via In-Vitro Fertilization (IVF). This treatment could vary from person to person, depending on the severity of the condition.

What are the symptoms?

Pain during menstruation is a common occurrence in women in the reproductive age group. However, severe uterine camps could often indicate an underlying condition.

The symptoms of it may vary from person to person. Some women can exhibit mild symptoms while some may have moderate symptoms.

Moreover, one can also have a severe form but may have very little discomfort. So, if you notice symptoms such as pelvic pain, painful periods, lower abdominal pain before and during menstruation, uncomfortable stomach or uterine cramps one or two weeks prior to your periods, pain after sexual intercourse, discomfort with bowel movements and lower back pain during menses then you must immediately consult your doctor who will rule out the exact cause of your pain. 

Can Endometriosis be treated?

Endometriosis cannot be permanently cured but it can surely be managed with an appropriate line of treatment. 

Pain managing medications, hormone therapy, laparoscopy (a minimally invasive surgery) can be used to deal with it. You will be suggested a treatment based on the stage of the condition. 

Does Endometriosis mean infertility?                                              

Infertility can be one of the complication of Endometriosis. Some women having endometriosis may find it difficult to get pregnant, as for pregnancy to occur an egg must be released from an ovary, travel via fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to start developing.

Having endometriosis may deteriorate the quality of eggs, disturb the tubo-ovarian relationship and hamper implantation of the fertilized egg, thus contributing to reduced fertility.

Still, some women with mild to moderate endometriosis can conceive and carry a pregnancy to term. It is imperative for a woman with Endometriosis to reach out and consult a fertility specialist.

A suitable treatment will be given to the women to help her conceive.

How can one conceive with Endometriosis?

 Those with endometriosis having fertility issues can also get pregnant and deliver healthy babies with the correct treatment and medication. 

The treatment may vary from person to person. Some patients may need fertility treatment such as IVF. IVF is commonly opted by couples who want to become parents and are facing challenges. 

In Vitro Fertilization (IVF) is one of the types of assisted reproductive technology (ART) that works using a combination of medicines and surgical procedures in order to help sperm fertilize an egg after which the fertilized egg is implanted in the uterus.

First, a woman is prescribed medication to make her eggs mature and ready for fertilization. Next, the doctor performs a procedure called egg retrieval, post which, the sperms and the eggs are fertilized in the IVF lab.

After that 1 fertilized eggs (embryos) of good quality is transferred into a woman’s uterus and the woman may become pregnant if the embryo implants itself in the lining of the uterus.

Some IVF clinics also transfer more than 1 embryo, but it is not advisable. Some patients may also need laparoscopic excision prior to attending IVF. 

Discuss with your doctor about the treatment suitable for you and opt for one accordingly.

By Dr. Ritu Hinduja, Fertility Consultant, Nova IVF Fertility, Mumbai