Understanding Endometriosis - A Common Fertility Problem

Endometriosis is one of the most common infertility problems that women face. It is considered a pelvic factor infertility problem. This condition occurs when normal endometrial tissue relocates in an abnormal place. It migrates outside of the uterus and implants itself within the pelvic cavity and it is there where it begins to grow. It can migrate over to an ovary or on a fallopian tube as well as many other places that it should not be present on.

The endometrium is the lining of the uterine cavity. It grows during every normal menstrual cycle. Its purpose is to be able to nurture a fetus. If a fetus does not implant, the endometrium breaks down and sheds along with the menstrual blood. It exits through the vaginal canal. This is often referred to as your period. Sometimes, it does not go as planned though. Retrograde menstruation is a backing up of menstrual blood. It pushes the blood through the fallopian tubes and into the pelvic cavity. During this retrograde menstruation, pieces of the endometrial tissue implants and grows under the influence of hormonal changes. At the end of the menstrual cycle, the blood will release into the pelvic cavity and react chemically, causing scarring and adhesions to form.

It is estimated that three to ten percent of all women suffer from endometriosis. Up to about 35% of infertile women have endometriosis. Endometriosis often includes the ovaries and the fallopian tubes. It can also travel into the blood stream or lymph system to pretty much any part of a woman's body. In some instances, it has been found in the bladder, colon and even in the brain.

Not all women that have endometriosis will have trouble conceiving. Only moderate to severe cases generally experience infertility. If there are adhesions or scarring in the fallopian tubes or in the ovaries, infertility is usually a concern. It can develop deep inside an ovary as well causing an endometrioma. An endometrioma is sometimes called a chocolate cyst. It can destroy the ovaries and fallopian tubes because of the chronic inflammation that it causes. It can also damage certain areas of the peritoneal surface. It creates massive scarring and can possible cause some of the pelvic structures to fuse together, which is not a good thing.

The most common symptom of endometriosis is severe pain with periods. This is called dysmenorrhea. Sex can also be extremely painful. It can be difficult to easily diagnose a woman with endometriosis. Some women do not experience the classic symptom of pain so that can cause trouble when trying to diagnose. The only distinctive way of diagnosing the disease is through laparoscopy. During a laparoscopy, the physician will insert a laproscope through the abdominal wall to view the pelvic organs. It is through this that a physician can see the scarring and adhesions.

If the physician sees any pelvic adhesions, he can remove them during a laparoscopy. That is not a guarantee that they won't come back but it can help to restore a woman's fertility so that she can conceive. During pregnancy, since there is no shedding of the uterine lining, endometriosis is not a factor. In some cases, it may not return after pregnancy. With some women, it does return but not as severely as before. It varies from person to person.

Physicians use a classification system of pelvic endometriosis. Stage One is classified as scattered spots of endometriosis on the surface of the pelvic peritoneum. There is no scarring or adhesions though. Stage Two is classified as the endometriosis implants will involve the surface of the fallopian tubes and ovaries. There may be areas of inflammation around the implants. Stage Three is classified as a larger area of endometriosis, which can include chocolate cysts or endometriomas. There are also adhesions on the ovaries or tubes. There can also be scarring involving the pelvic floor and large intestine. Stage Four is classified as endometriosis in both ovaries, as well as thick scarring around the pelvic organs. It can involve the intestines, bladder and other pelvic abdominal organs. There can be obstruction of one or both fallopian tubes. It is important to determine the severity of each individual case as to know which direction to go with regards to treatment options. Many times, treatment can begin with the original laparoscopy.

If your disease is in Stage One or Stage Two, your doctor will probably use hormonal treatments to try to shrink or eliminate your lesions. With Stage Three or Stage Four, the doctor will probably treat surgically instead. If the endometriosis is more advanced, the doctor may try both options, hormonal as well as surgical treatments.

However your physician approaches your individual case, keep a positive attitude. Although endometriosis can be a bothersome, fertility problem, it doesn't have to be an end to your fertility goal. More women than not do conceive with a diagnosis of endometriosis. Just keep in mind why you are going through treatments, to achieve the best gift of all....a baby.