Incurable but manageable, endometriosis plagues an estimated 11% of American women between the ages of 15 and 44. This condition occurs when uterine tissue grows outside of the uterus, causing painful growths where there shouldn’t be extra tissue.
Endometriosis, often called “endo,” gets its name from the endometrium, or the lining of the uterus. Most often, the extra tissue present from endometriosis is found on the ovaries, fallopian tubes, outer surface of the uterus, or other tissues surrounding the uterus. The extra tissue can also appear on the vagina, cervix, vulva, bladder, or other areas in the proximity.
Endometriosis can cause a great deal of related health complications, such as abdominal pain, heavy or prolonged periods, scar tissue, intestinal or bladder issues, back pain, and fatigue.
But there’s one thing that most women with endometriosis are ultimately concerned about: Getting pregnant. It’s true that most women with endometriosis will experience trouble when it comes to conception, but it’s impossible to make a blanket statement that endometriosis causes infertility in all women.
Let’s dig a little deeper into the causes of endometriosis, pregnancy outcomes, and treatment options.
Causes of endometriosis
Scientists aren’t sure of the exact cause of endometriosis, but possible explanations include:
- Problems with menstruation: Menstrual blood follows an abnormal route.
- Embryonic cell growth: Embryonic cells lining the abdomen may develop into endometrial tissue outside of the uterus.
- Surgery: If you’ve had a procedure like a hysterectomy or C-section, endometrial cells can move during or after.
- Cell transport: Your lymphatic system transports cells, and it may transport endometrial cells to areas where they don’t belong.
- Genetics: You’re more likely to develop endometriosis if a first-degree relative, such as your parents, full siblings, or children, also has the condition.
- Hormones: Too much estrogen can contribute to endometriosis.
- Immune system: Normally, your immune system would destroy tissues where they don’t belong, but issues with the immune system may prevent proper targeting.
Does endometriosis cause infertility?
Technically, no. There’s currently no causal relationship between endometriosis and infertility, but research is ongoing. Some research suggests that an estimated 30-50% of women with endometriosis will experience infertility, which is defined as failure to conceive after trying for one year. Other research has pinpointed endometriosis as a risk factor for miscarriage.
Doctors and scientists don’t yet understand the exact mechanisms that cause fertility problems in women with endometriosis, but they think it may be due to:
- Blocked reproductive organs
- Distorted reproductive organs
- Inflammation of reproductive and pelvic organs
- Decreased egg quality
- Problems with embryo implantation
However, not every woman with endometriosis will struggle to get pregnant or experience pregnancy complications, and women without endometriosis can still experience infertility from other causes.
How to conceive when you have endometriosis
If you have endometriosis and haven’t tried to get pregnant, you should definitely try to conceive naturally before seeking help from a fertility doctor. As a general rule, you should seek treatment after one year of trying to conceive, with no success. Some doctors may recommend you seek treatment after six months of attempts if you have endometriosis.
If you receive an infertility diagnosis, you have a few treatment options:
First, you can consider surgical removal of the extrauterine tissue. Surgery appears to increase success rates for fertility treatments down the line, and research has shown that removal of extrauterine tissue improves live birth rates.
Intrauterine insemination (IUI)
This procedure may be done with or without fertility drugs as an extra helper. It involves transferring semen to the uterus via a small tube.
In vitro fertilization (IVF)
Considered the most effective fertility treatment available, IVF involves a lengthy egg production and egg removal process, followed by replacement of fertilized eggs into the uterus.
To learn more about endometriosis and fertility, visit our endometriosis FAQ. To schedule a consultation appointment with Dr. Kushner, call today, send us a message here on our website or request an appointment online at one of our New York locations.