How Endometriosis Causes Infertility

Endometriosis, a very far-reaching a devastating disease, affects about 70 million women and girls worldwide. It is more common than breast cancer and HIV/AIDS. It is becoming more and more common, especially in developed countries, so information has been made more available, making diagnosis, and treatment more attainable to women who are suffering from this condition.

Endometriosis, A Silent Robber

Essentially, endometriosis is a biological malfunction focused primarily in the region of the pelvis and reproductive organs of a woman's body. It begins quietly, often in the early teen years, and gradually, symptoms of painful menstrual periods, general malaise, and abdominal pain develop. The result is a malfunction of the natural bodily processes of the reproductive system. The disease seriously affects hormones and that in turn affects the menstrual cycle and fertility. A progressive disease, endometriosis does not improve over time but rather worsens. It can also recur after treatment.

Endometriosis can be a cause of female infertility. In fact, 30-40 percent of women with endometriosis are infertile-two to three times the rate of infertility in the general population. The chance of becoming pregnant decreases by 12-36 percent for women with endometriosis. However, women with mild cases of endometriosis do have much higher fertility rates than those with more severe cases.

What Is It And What Does It Do?

What is endometriosis? The tissue that lines the uterus grows outside the uterus and attaches to other organs in the pelvic cavity, like the fallopian tubes and ovaries. This tissue, whether inside or outside the uterus, responds to menstrual cycle hormones by swelling and thickening, then shedding when not housing a fertilized egg. Since the tissue in the pelvic cavity has nowhere to go once it is shed, it pools in the cavity and causes inflammation that forms scar tissue. The scar tissue can block the fallopian tubes or interfere with ovulation. Ovarian cysts, called endometrioma, can also form. They, too, interfere with ovulation. Adhesions in the pelvic cavity can become so extensive that they freeze all of the reproductive organs into place. The eggs themselves end up wrapped and encased in scar tissue that smothers the ovaries. Infertility is the result.

More Ways It Interferes With Fertility

Endometriosis does not have to be in later stages to interfere with fertility. It is thought that prostaglandins, which come from either endometrial implants or other chemicals and are secreted by white blood cells, may cause muscle spasms and contractions. The fallopian tube may not be able to catch the egg with the feathery, finger-like projections at the flared end of the tube when the egg is expelled from the ovary.  Another cause may be within the uterus, which has been stimulated, and may reject the implantation of the fertilized egg. All of this hormonal activity may affect sperm motility and the ability of the sperm to penetrate into the egg may also be affected.

There are no easy answers, but there are several solutions offered as a means of helping women with endometriosis fulfill their desire to become mothers. We will explore them in this section of Women's Health.


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