Last Updated on August 4, 2023 by Shabnam Sengupta
Infertility is a condition of being unable to conceive or get pregnant after at least one year of trying. In this article, we will discuss how endometriosis causes infertility and how you can manage infertility in endometriosis.
Does endometriosis lead to infertility?
Yes, endometriosis can cause infertility. According to research, up to about 50 percent of women suffering from endometriosis are infertile. Infertility in endometriosis can be a result of various factors including hormonal and other changes.
How can endometriosis cause infertility?
The causes of infertility in women with endometriosis can be highly variable. The reasons can be anatomical distortions due to adhesions, endocrinal abnormalities and immunological disturbances because of the growth. However, in a few cases, there is a lack of understanding of the various mechanisms for pathophysiological disturbances with this condition.
Recent investigations have shown that altered prostaglandin (PG) secretion and metabolism can cause infertility due to endometriosis. There is an increase in level of prostaglandins in the peritoneal fluid (a fluid that peritoneum in the abdominal cavity creates, which lubricates tissue that lines the abdominal wall and pelvic cavity) of patients with endometriosis.
Additionally, there is also an increase in the volume of peritoneal fluid in such cases. The increased concentration of peritoneal fluid affects ovarian function and tubal motility (mobility of the fallopian tube). Many women with endometriosis may have a luteal phase defect (a defect of a woman’s ovulation cycle which may be a result of low progesterone levels and limited uterine lining growth). Lastly, there is also a belief that endometriosis causes infertility as an autoimmune response.
How is infertility with endometriosis treated?
If endometriosis affects fertility, laparoscopic surgical removal of endometriosis, ovarian stimulation with intrauterine insemination (IUI), and in vitro fertilization (IVF) can be helpful.
Treatment of endometriosis, including surgical ablation or resection, is cost-effective and offers the potential for improvement in cycle fertility.
Current evidence indicates that suppressive medical treatment of endometriosis does not benefit fertility and should not be used for this indication alone. Surgery can be beneficial in all stages of this disease. Doctors may recommend controlled ovarian hyperstimulation with intrauterine insemination in early-stage and surgically corrected endometriosis. However, in advanced cases, in vitro fertilization, along with the prolonged gonadotropin-releasing hormone, is a treatment of choice. Research on treatment options for endometriosis-associated infertility states that just medical or hormonal treatment alone has barely any effect. You should use it in conjunction with assisted reproductive technology (ART). Amongst ART methods, doctors recommend intrauterine insemination in women with minimal or mild peritoneal endometriosis. In vitro fertilization (IVF) is effective in less-advanced disease stages. However, women with more advanced stages of endometriosis have lower success rates.
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