Does Endometriosis Cause Infertility: An In-Depth Study

Endometriosis not only causes chronic symptoms but also impacts fertility.

Approximately 30-50% of individuals with endometriosis may experience infertility.

Understanding the causes of endometriosis and its effects on fertility is crucial for those planning to conceive.

Let’s delve into how does endometriosis cause infertility, offering insights into its challenges and possible solutions.

A] What is Endometriosis?

Endometriosis affects a significant number of women, with around 1.5 million reported cases. It is the second most common gynaecological disorder after fibroids. It is a severe condition where tissue that is very much like the lining of the uterus grows outside the uterus, often creating chronic pain. It disrupts ovulation and affects the quality of the eggs and the ability to conceive.

The most common signs or symptoms include intense pelvic pain during menstruation, sexual intercourse, or bowel movements, chronic pelvic pain, heavy menstrual bleeding, fatigue, and emotional distress like depression or anxiety. These signs can vary in acuteness and may not always be present. Despite the challenges posed by endometriosis, pregnancy is still possible, although it may be more difficult. 

The best age to get pregnant with endometriosis is typically before the age of 35, as fertility declines with age. However, with proper management as well as treatment, many individuals with endometriosis can still conceive. Early diagnosis and intervention are extremely important for managing symptoms and improving the chances of pregnancy. Signs and symptoms of endometriosis should be monitored closely for timely intervention.

B] How Does Endometriosis Impact Fertility?

50% of women seeking fertility treatment are affected by endometriosis, which is known to reduce fecundity. While not all individuals with endometriosis experience infertility, the condition can indeed reduce the chances of conceiving naturally. Understanding the reasons behind endometriosis and pregnancy is crucial for those planning to conceive and seeking appropriate medical guidance.

1. Inflammation and Scarring

Endometriosis triggers chronic inflammation in the pelvic region, forming scar tissue or adhesions all around the reproductive organs. These adhesions can distort the anatomy of the pelvis, affecting the normal functioning of the fallopian tubes, ovaries, and the uterus. Scar tissue can impair the mobility of reproductive organs, hindering the release of eggs during ovulation and the passage of sperm through the fallopian tubes.

2. Adhesions and Distortion of Anatomy

Endometriosis and its effect on fertility can distort the normal anatomical structures of the reproductive system, preventing the proper alignment of the ovaries, fallopian tubes, and uterus. This distortion can impede the movement of eggs and reduce the chances of conception by not letting the eggs enter the fallopian tubes through the ovaries for fertilization. Additionally, distorted anatomy may interfere with the implantation of a fertilized egg into the uterus, further impacting fertility.

3. Hormonal Imbalances

Endometriosis is associated with hormonal imbalances, particularly elevated levels of estrogen. These hormonal fluctuations can disrupt the menstrual cycle, leading to irregular ovulation or anovulation (lack of ovulation). Without well-regulated ovulation, the chances of conceiving naturally are diminished. Hormonal imbalances can also affect the quality of eggs and the receptivity of the uterine lining, making successful implantation less likely.

4. Impaired Ovulation

Endometriosis can interfere with ovulation, the process by which the ovaries release mature eggs for fertilization. Ovulation may be irregular or absent in individuals with endometriosis, reducing the opportunities for conception. Even if ovulation occurs, the quality of eggs may be compromised due to the inflammatory environment created by endometriosis, reducing the likelihood of successful fertilization.

5. Altered Immune Response

Endometriosis is connected with alterations in the immune system, leading to abnormal immune responses within the pelvic cavity. These immune dysfunctions may impair fertility by affecting the interaction between sperm, eggs, and the uterine environment. Additionally, immune dysfunction can contribute to the persistence of inflammation and the formation of adhesions, further compromising fertility.

6. Pain and Psychological Stress

]Chronic pelvic pain, a hallmark symptom of endometriosis, can have a major effect on psychological well-being and sexual function. Painful intercourse and emotional distress associated with endometriosis can lead to sexual dysfunction and relationship strain, indirectly affecting fertility. Moreover, psychological stress may exacerbate hormonal imbalances and immune dysfunction, creating additional barriers to conception.

C] Fertility Treatments for Women with Endometriosis

For women with endometriosis who are struggling to conceive and are wondering if you have endometriosis, can you get pregnant? Then, know that several treatments for fertility are available that can help improve your chances of becoming pregnant.  Endometriosis impacts approximately 10% (190 million) of reproductive-age women and girls worldwide.

While infertility signs and symptoms of endometriosis can pose challenges, many women with the condition can successfully conceive with appropriate medical interventions and support.

1. Ovulation Induction

Ovulation induction includes the use of medication to encourage the ovaries to create more eggs than usual during a menstrual cycle. This approach can be beneficial for women with endometriosis who have irregular or absent ovulation. By stimulatinhg the development and release of mature eggs, ovulation induction increases the likelihood of conception, especially when timed with intercourse or assisted reproductive techniques.

2. Intrauterine Insemination (IUI)

Intrauterine insemination, or IUI, includes placing sperm directly into the uterus right near the time of ovulation. This procedure can bypass potential barriers to conception posed by endometriosis, such as distorted anatomy or impaired sperm transport through the cervix. IUI is often combined with ovulation induction to optimize the chances of fertilization and pregnancy.

3. Intrauterine Device (IUD)

While traditionally used as a contraceptive method, certain types of intrauterine devices (IUDs) have shown promise in managing symptoms associated with endometriosis. Hormonal IUDs release progestin locally into the uterus, which can help alleviate pelvic pain and reduce endometrial tissue growth outside the uterus. By controlling symptoms, IUD for endometriosis may indirectly support fertility by creating a more favorable environment for conception.

4. In Vitro Fertilization (IVF)

IVF, or In Vitro Fertilization, is a highly effective fertility treatment that can benefit women with endometriosis who have not achieved pregnancy with other methods. IVF includes getting the eggs from the ovaries, then fertilizing them with sperm in a laboratory, as well as transferring the resulting embryos into the uterus. By bypassing the fallopian tubes, where endometriosis-related factors may impair fertility, IVF can offer a successful pathway to pregnancy for many women with endometriosis.

5. Surgery

Surgical intervention may be considered for women with endometriosis-associated infertility, particularly in cases where anatomical abnormalities or extensive disease burden are identified. Laparoscopic surgery carried out through small incisions in the abdomen, can remove endometriosis lesions, adhesions, and scar tissue, potentially restoring reproductive organ function and improving fertility outcomes. Surgical treatment should be tailored to individual needs and may be combined with other fertility interventions for optimal results.

6. Lifestyle Modifications and Support

Lifestyle modifications, like keeping a healthy weight, managing stress, and adopting a balanced diet, can complement medical treatments for endometriosis-related infertility. Supportive therapies, including acupuncture, yoga, and counseling, can help reduce stress as well as promote overall well-being during the fertility journey. Partner support and involvement in treatment decisions are also vital for navigating the emotional challenges of infertility and optimizing treatment outcomes.

D] Can You Get Pregnant With Endometriosis?

It is assessed that 60-70% of women with endometriosis can get pregnant spontaneously. So, can you have kids with endometriosis? Yes, it’s possible to conceive and have children with endometriosis, although the condition may make it more difficult. Endometriosis can affect fertility, but many women with the condition still become pregnant naturally. Fertility treatments such as ovulation induction, Intrauterine Insemination (IUI), as well as In Vitro Fertilization (IVF) can also assist in conception. 

While endometriosis can pose challenges to pregnancy, seeking guidance from a reproductive specialist can provide options and support for those hoping to conceive. With appropriate medical management and sometimes assisted reproductive technologies, many women with endometriosis can have successful pregnancies.

Conclusion

Getting pregnant with endometriosis may seem difficult, but with the right support and treatment, it’s entirely feasible. Seeking specialized care, such as endometriosis treatment in London, can provide tailored solutions and invaluable assistance. By staying informed, proactive, and resilient, individuals with endometriosis can confidently pursue their goal of pregnancy. Remember, you’re not alone in this journey!

Neha Goel

Neha Goel, a Psychology alumna and MBA graduate from CASS Business School, London, brings together her expertise as a Reiki Practitioner and Practice Manager. She integrates psychology and business strategies to foster holistic well-being and personal development.