Infertility rates have been rising globally due to the prevalence of various health issues in women over the past few decades. According to the WHO, endometriosis affects almost 10 per cent (190 million) of women in the reproductive age category. Dr Prachi Benara, Consultant – Birla Fertility & IVF MBBS (Gold Medalist), MS (OBG), DNB (OBG), helps us understand what endometriosis is and how it affects fertility in women.
What Is Endometriosis?
Endometrium, or the lining of the uterus, is the tissue found inside the uterus which is responsible for hosting the embryo at the time of pregnancy. Endometriosis is a condition when endometrial tissue grows outside the uterus and causes inflammation, leading to chronic pain in the pelvic region. “During each period cycle, the endometrial-like tissue breaks, and starts bleeding. At times, cysts known as endometriomas may form within the ovaries, developing scars and adhesions. These can eventually lead to severe pain and cause infertility over time,” adds Dr Benara. Women suffering from endometriosis may often have symptoms involving pain and severe cramps during their menstrual cycle, heavy bleeding during periods, pain during sexual intercourse, inflammation during urination or bowel movements, and lastly, infertility.
How Does Endometriosis Affect Fertility?
As a woman develops endometriosis, complications like infertility might occur; 30-50 per cent of women with endometriosis may face difficulties in conceiving. Endometriosis can distort the anatomy of the pelvis region due to inflammation, scarring and adhesions. It can alter the immune system and change the hormonal milieu. At times, the process of ovulation can get hampered as follicle growth due to inflammation can get altered. Further, endometriosis can affect the fallopian tubes, which may become nonfunctional due to adhesions and inflammation. Being a part of the uterus’ inner lining, it can fail to provide favourable conditions for embryo implantation if damaged.
Diagnosing And Treating Endometriosis
Endometriosis presents with classical symptoms of pelvic and abdominal pain aggravated during periods and intercourse. As first steps, your gynaecologist will conduct pelvic examination to identify formations of cysts or other abnormalities present in the pelvic region. Ultrasounds and MRI scans are also used to diagnose more accurate results, which may help your doctor locate and identify the size of endometrial tissues present. “Sometimes your doctor may recommend laparoscopy, which is carried out by inserting a camera for precise diagnosis. This test can both diagnose and treat the disease through surgery at the same time,” says Dr Benara.
Treatment for infertility with endometriosis is usually done through Intrauterine Insemination (IUI) with ovarian controlled stimulation if the patient has mild endometriosis. If IUI fails to deliver results, IVF is the next preferred choice of treatment. If one is diagnosed with severe endometriosis, surgery is often recommended, involving the burning of endometrial-like tissue in the pelvic region, and removal of endometrioma may be considered. Higher chances of conceiving follow a treatment involving IUI or IVF.
Dr Benara says that it is essential to diagnose and get endometriosis treated as soon as possible as it may hamper quality of life and increase complications of conceiving over time. Since it has a high reoccurrence rate, the treatment process should be ongoing and not be neglected at any period.
Read more: Know Your Fertility Score: When To Go For IVF Treatment
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