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Endometriosis

Infertility

It may take longer to become pregnant if you have endometriosis; and for many women, the condition renders them completely infertile. Doctors often recommend their patients not delay having children because endometriosis is a progressive disease, so the longer you have it, the greater your chance of becoming infertile. Endometriosis can cause infertility for the following reasons:

  • Scar tissue from endometriosis can form adhesions on the ovary and limit the release of eggs.

  • New research has shown that women with endometriosis-related infertility lack a certain enzyme in their uterus that allows an embryo to attach to the uterine wall, thereby preventing pregnancy.

  • Adhesions affecting the fallopian tubes may interfere with their ability to pick up an egg released by an ovary and transport it to the uterus.

  • Lesions may form inside a fallopian tube, blocking it and making fertilization impossible.

  • Endometriosis can disrupt the ovaries' normal cycle of egg development and release.

  • The peritoneal fluid in women with endometriosis contains an increased number of scavenger cells, which have the ability to destroy sperm cells, making fertilization unlikely.

  • In advanced stages of endometriosis, internal organs may fuse together causing a condition known as a "frozen pelvis."

Pregnancy rates following treatment for endometriosis range from approximately 35 to 65 percent; however, the more endometriosis a patient has, the less likely she is to become pregnant following treatment. Medical or surgical treatment of mild endometriosis will not dramatically increase a woman's chance of becoming pregnant; however, women with severe endometriosis may improve their chance by undergoing surgical treatment. Infertility treatment for women with endometriosis usually involves ovarian stimulation and intrauterine insemination, followed by IVF and GIFT if necessary. Unfortunately, ovarian stimulation and intrauterine insemination are often unsuccessful in women with severe endometriosis, especially if the pelvic anatomy is very distorted. However, pregnancy rates using IVF and GIFT are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation.

Support

Women who suffer from endometriosis may find advice, information, and help from support groups who specialize in endometriosis. The Endometriosis Association is a self-help organization of women with endometriosis and others interested in exchanging information about endometriosis, offering mutual support and help, educating the public about the disease, and promoting research. Another support group, Endometriosis.org, facilitates collaboration and information sharing between women with endometriosis, clinicians, and scientists.

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