Endometriosis and Infertility

While endometriosis is best known for the chronic pain and suffering it causes, this complex condition is also a leading cause of infertility in women – one that may go undetected and untreated for years.

Nearly 4 in 10 women experiencing infertility have endometriosis, according to the American College of Obstetricians and Gynecologists. 

Symptoms of the disease vary for each patient, and in many cases women with endometriosis don’t experience symptoms. Their condition may not be diagnosed until the woman has difficulty getting pregnant. In cases of unexplained infertility, endometriosis can often be involved. 

Diagnosing endometriosis can be challenging for providers less familiar with the disease, causing lengthy delays in treatment. Specialized care is important for timely, accurate diagnosis, preventing the condition from worsening over time and helping preserve fertility.

Endometriosis occurs when cells similar to the lining of the uterus, known as the endometrium, grow in other areas of the body, typically the pelvic region. 

This abnormal tissue can irritate the surrounding tissues and organs, including the ovaries and fallopian tubes, causing inflammation, pain, bleeding, the development of thick bands of scar tissue (adhesions), and infertility.

While much remains to be understood about endometriosis and its impact on fertility, the condition may make it more difficult to become pregnant due to:

• Damage to the ovaries caused by scar tissue or inflammation
• Endometriosis tissue growth inside the ovaries, leading to ovarian cysts known as endometriomas which can affect the number of eggs in the ovary (a woman’s “ovarian reserve”) 
• Blocked fallopian tubes caused by endometriosis lesions or scar tissue, preventing eggs from reaching the uterus
• Adhesions and scar tissue that bind organs together, altering the anatomy of the pelvic area 

Treatment for endometriosis-associated infertility should be tailored to each patient based on the severity of their disease, their age, medical history, and a complete fertility evaluation.    

Treatment options may include:

• Medication to induce ovulation 
• Fertility medications in combination with intrauterine insemination (IUI) 
• Referral to Baylor College of Medicine endometriosis specialists to discuss a possible role of excision surgery to remove endometriosis tissue, scar tissue and endometriomas, restoring normal pelvic anatomy and improving the function of the reproductive organs 
• In vitro fertilization (IVF) 
• A combination of surgical and medical treatment

For more information or to schedule an appointment, call the Family Fertility Center at (832) 826-7272.