The link between endometriosis and infertility

The relationship between endometriosis and infertility has been debated for many years. Ultimately, there is still more to be done and much research needed into finding out why and how the condition affects fertility.

Below we have listed several possibilities which may contribute to having a challenging pregnancy.

Inflammation

 

Besides infertility, there are several gynaecological conditions (such as, endometriosis, polycystic ovary syndrome, pelvic inflammatory disease and adenomyosis) that all have something in common, inflammation. Inflammation is heavily linked to infertility. Not only does it cause chemicals such as cytokines which are known for causing an unhealthy environment for pregnancy to take place, cytokines can also affect the quality of the egg and the sperm. The role of inflammation has also been linked to exhibiting the sperm and egg from reaching one another, implanting, and forming into a pregnancy, making fertilisation more difficult.

 

The location of scar tissue

 

Endometriosis can cause scar tissue. When this tissue attaches itself to the reproductive organs, there is a chance the fallopian tube(s) can become partially or entirely blocked. This can interfere with the communication between the sperm and the egg, stopping them from reaching one another and preventing the fertilised egg from reaching the uterus. When the fallopian tube(s) is blocked it can jeopardise the pregnancy process and there is a chance it can lead to a more serious problem, such as an ectopic pregnancy.

An ectopic pregnancy

An ectopic pregnancy occurs when a fertilised egg implants itself outside of the womb, usually inside the fallopian tube. Unfortunately, this kind of pregnancy cannot be saved, and it is usually removed either by taking medication or by undergoing an operation. As a result of this, some may experience the loss of the fallopian tube.

The pelvic structure

Endometriosis can affect the structure of the pelvis by distorting the pelvic organs. This can interfere with the function of the uterus, by stopping it from contracting the way it is supposed to. This can also hinder the process of the sperm reaching the egg, affecting your chances of natural conception.

Ovarian endometriosis

An ovarian endometrioma is a type of cyst which forms when endometriosis is found on or inside one or both ovaries. These cysts tend to grow larger than simple cysts, which usually disappear by themselves without causing problems. Endometriomas are filled with tissue and old blood which gives them a dark ‘chocolate like’ appearance.

 

There is a chance a ruptured endometrioma can lead to partial or complete damage of the ovary and its function by destroying healthy ovarian tissue. This can sometimes lead to Primary Ovarian Insufficiency (POI) or previously known as premature ovarian failure which is also often referred to as ‘early menopause’.

 

Surgical treatment to remove an ovarian endometrioma may not always recommended, this is because of the risks of causing further damage to the ovary.

 

Pain medications

 

Pain medications such as non-steroidal anti-inflammatory medications (NSAID’s) such as ibuprofen and mefenamic acid, have been known to interfere with ovulation, especially when they’re taken for long periods of time or around the time of ovulation.

 

If you are prescribed long term medications, consider discussing an alternative with your medical team if the original medication is known to have an effect on fertility health.

Hormone treatments

 

Some hormone treatments can delay the chances of becoming pregnant, acting as a contraceptive.

 

Painful sex

Pain (and sometimes bleeding) during and/or after sexual intercourse is one of the common symptoms of endometriosis which can often make it difficult for couples to engage in regular unprotective sex.

Being underweight or overweight

 

Being overweight has been linked to an increase of oestrogen inside the body. Being underweight is not good for fertility health either, as this has been linked to problems with ovulation. Maintaining a healthy weight and carrying our regular exercise can not only help you keep active and stay in shape, but exercise can also help with lowering stress levels, which is great for fertility health. 

Adenomyosis and Fibroids

There is a higher risk of miscarriage in those who have Adenomyosis and Fibroids. Both conditions often co-exist with endometriosis.

 

Conclusion

Endometriosis can prevent pregnancy in many ways.