Endometriosis is a medical condition when tissue that normally lines the inside of your uterus (endometrium) starts growing outside your uterus. Those tissues can spread to organs in your pelvis including ovaries and fallopian tubes. Those tissues bleed every month when you menstruate as the normal endometrium, but the blood will trap in your pelvis, causing chronic inflammatory disease and subsequent infertility.
How do I know whether I have Endometriosis?
You may have endometriosis if you have:
– Pain with periods.
– Pain with intercourse.
– Heavy, prolonged, and irregular periods.
– Bulky, enlarged uterus with ultrasound features of endometriosis in the uterine muscle layer (Adenomyosis).
– Pelvic or fallopian tube fluid collection (Hydrosalpinx) that can be detected through ultrasound.
– Endometriosis on the ovary (Endometrioma) that can be detected through ultrasound.
The definitive diagnosis of endometriosis is Laparoscopy procedure, which will be performed under general anesthesia. A laparoscopy can not only provide information about the location, extent, and size of the endometrial implants, but also treat endometriosis at the same time so that you need only one surgery for diagnosis and treatment.
Endometriosis can disrupt fallopian tubes and ovaries, causing blocked fallopian tubes or diminish ovarian reserve. For infertility caused by endometriosis, rates of pregnancy are much improved with IVF treatment.
Exactly which IVF protocol is right for you depends on a variety of individual factors such as severity of the endometriosis, your age and your ovarian reserve. We tailor your IVF protocol based on your specific situation and needs.
One concern about IVF treatment is that IVF medication and high estrogen level during ovarian stimulation may exacerbate endometriosis. In those women, mild stimulation IVF treatment might be a good option to minimize the side effects of medication. Talk to us about your situation. We can advise you on the best course of action for your specific situation.
In general, when a woman has significant symptoms such as pain unable to be controlled with pain medication or birth control pills, or has severe endometriosis, laparoscopy surgery to remove the endometriosis tissue is recommended.
For mild endometriosis, whether laparoscopy can improve the pregnancy rates is somewhat controversial. If there is an endometriosis cyst on the ovary, removal of the cyst can potentially cause loss of normal ovarian tissue and eggs, causing subsequent lower ovarian reserve and make it harder to become pregnant. So, careful decision-making is advised when considering surgery.