What to know about endometriosis and infertility?

Endometriosis is a condition in which tissue similar to the uterine lining grows elsewhere in the body. Pelvic pain is the most common symptom of endometriosis, but some women with the condition may also experience infertility.

Research has found that  infertility affects around  30-50 percent of people with endometriosis

Endometriosis lesions can cause inflammation in the area and may form scar tissue, as well as stick different organs together. They also bleed, similarly to the regular uterine lining, in response to hormones. All of these things can cause pain.

In addition to infertility, other symptoms of endometriosis include:

  • pain during sex
  • pain with ovulation
  • fatigue
  • painful cramps
  • frequent urination
  • low back pain
  • painful bowel movements
  • constipation or diarrahea

Symptoms tend to get worse around the time of a person's menstrual period.

Endometriosis and infertility

Infertility is a common symptom of endometriosis. Some people only find out that they have the condition when they experience difficulty getting pregnant.

Although researchers do not know exactly why this is, they do have a few theories, including:

  • Inflammation causes the production of chemicals known as cytokines. These cytokines can inhibit the sperm and egg cells, making fertilization more difficult.
  • Scarring and adhesions that occur with endometriosis can block the fallopian tubes or uterus, making it difficult for the sperm to meet the egg.
  • Endometrial tissue on the ovaries can inhibit ovulation, preventing the release of an egg.

Causes

Although the exact cause of endometriosis is not certain, possible explanations include:

  • Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
  • Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
  • Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.
  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
  • Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.

 

Treatment

Treatment for endometriosis usually involves medication or surgery. The approach you and your doctor choose will depend on how severe your signs and symptoms are and whether you hope to become pregnant.

Lifestyle and home remedies

If your pain persists or if finding a treatment that works takes some time, you can try measures at home to relieve your discomfort.

  • Warm baths and a heating pad can help relax pelvic muscles, reducing cramping and pain.
  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), can help ease painful menstrual cramps.
  • Regular exercise may help improve symptoms