Endometriosis and Infertility

Endometriosis is the implantation of endometrial-like tissue outside the uterus, causing pain, heavy periods, and infertility. The cause is unknown, but it likely begins during fetal development. Endometriosis can reduce fertility rates, even with little anatomical impact. It may also alter peritoneal fluid composition, affecting folliculogenesis and embryo development. Treatment options include surgery, superovulation, intrauterine insemination, and in vitro fertilization. Success rates vary depending on factors such as age and stage of endometriosis. Overall, there are ways to address infertility caused by endometriosis and help people create the families they desire. Hi everyone and welcome back to the podcast. Today we will be talking about all about endometriosis, its causes, how it affects fertility and some treatments for endometriosis related infertility. So what is endometriosis? According to Massachusetts General Hospital, endometriosis is the implantation of tissue that looks and acts like endometrial tissue outside of the uterus. So what might be the cause of this? In a video produced by the Mayo Clinic, Dr. Megan Wasson tells us that there is currently not a definitive cause, but it is likely that the beginning of endometriosis occurs during fetal development. Endometriosis can have many effects on a person including significant pain, heavy periods, and infertility. According to a journal review by Maverlose, endometriosis can reduce a person's fertility rate by two to ten percent per month. This is a very drastic change from normally fertile women, so let's talk about how it affects the body. As mentioned before, endometriosis causes an implantation of endometrial-like tissue to the outside of the uterus. This creates a change in the pelvic anatomy and can cause a disturbance in the relationship between the ovaries and fallopian tubes, says Maverlose. But even little or no anatomical impact can reduce fertility. Maverlose goes on to explain that along with a potential anatomical impact, endometriosis may alter the composition of peritoneal fluid, which can then create changes in folliculogenesis, leading to lower quality oocytes, which can decrease fertilization rates, embryonic development, and implantation. Now we know how endometriosis physiologically affects infertility, so how can these be treated? Treatment of infertility in those with endometriosis includes surgery or assisted reproductive techniques. The right treatment for each person with endometriosis will differ depending on age, duration of fertility, ovarian reserve, sperm analysis, history of previous surgeries for endometriosis, and case severity, says Maverlose. Masur discusses treatment options more in depth as surgery, superovulation, intrauterine insemination, and in vitro fertilization. According to Mass General Hospital, the goal of surgery is to remove abnormal tissue that is built up using a laparoscope. Superovulation and intrauterine insemination are used and most effective in those with early stages of endometriosis. First, the patient goes through surgery to remove any tissue buildup, then is given fertility medication. During ovulation, a sperm sample is collected from the partner and is placed into the uterus of the patient. It is recommended by Brigham and Women's Hospital to continue this process for three months, and if not successful, the next step would be in vitro fertilization. This process requires the person being treated to take fertility medication through injections. From Brigham and Women's Hospital's article, this medication causes many eggs to grow in the ovaries. When the eggs have reached a certain size, they are removed from the ovaries to be fertilized in a fertility laboratory. With the hope that a few embryos have formed, the patient returns for the final stage of this treatment, which is to place the embryos into the uterus. The success rate of each treatment option varies depending on age, stage of endometriosis, and previous treatments. So, in conclusion, endometriosis is the implantation of endometrial- like tissue to the outside of the uterus, which can cause pain, heavy periods, and infertility. But there are steps that can be taken to combat infertility, including surgery, supraovulation and in-tube uterine insemination, and in-vitro fertilization, which may give people the ability to create the families that they desire.