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What is Endometriosis?
Pronounced as (En-Doe-me-tree-O-sis), it is a tissue disorder that can often be extremely painful. The uterus has a lining called the endometrium lining which thickens over time during the monthly cycle. People suffering from endometriosis, have the same tissue growing outside the lining of the endometrium.
Since the tissue is a part of the endometrium, it acts the same. Hence it thickens, breaks itself down, and bleeds. Normally when this happens, the blood exits itself through the vagina. However since the endometrial-like tissue does not have an exit, it becomes trapped in the body.
With Endometriosis, the change in hormones during the cycle can cause the area to become inflamed and painful. Hence the tissue will thicken itself, break down and bleed. Over time, it starts to involve ovaries, fallopian tubes, and the tissue lining. When the ovaries get affected, this can form cysts called Endometriomas.
Stages of Endometriosis
There are primarily four stages of Endometriosis which can range from basic to extreme. They are the following:
- Minimal (Stage 1) – This is the first stage wherein there are very few small wounds or lesions. It may be found on the organs or the tissue lining of the pelvis or abdomen. It may have little to no scar tissue.
- Mild (Stage 2) – Along with some scar tissues, the wounds can be more and deeper into the tissue lining.
- Moderate (Stage 3) – Adhesions can be found which can be defined as thick bands of scar tissues. The wounds may be much more in number and be deep. Small cysts on either or both ovaries can be found.
- Severe (Stage 4)– The wounds can be really deep. Thick adhesions and large cysts either or both of the ovaries. This is the most far-flung.
Endometriosis and Infertility
Women with endometriosis have a chance of becoming infertile. Approximately one-third to half of the women have difficulty getting pregnant. The fertility rate with women having endometriosis is about 0.02-0.1 per month. Normally it ranges from 0.15-0.20. However it depends, women with minimal to mild stages can get pregnant without treatment.
With that being said, the exact relationship between endometriosis and infertility is yet to be explored but looking at the severity and the location of the tissue, it seems to have a possible effect. For example, mild lesions may not cause trouble but a severe stage is bound to cause some change in the anatomy. However, it is not true that women with severe endometriosis cannot conceive naturally but the chances may be low. This has been found true with 70% of women having endometriosis.
Fertility Treatment options
So far, the world has not seen any cure for endometriosis but certain treatments and medications help if you want to get pregnant or otherwise.
- Powering through the pain– Painkillers might be your best friend at this time should you feel any pain. Medicines like paracetamol, Codeine NSAIDs, etc. However, painkillers should be kept to a minimum especially when you are trying to have a baby.
- Surgery– If you have minimal to mild symptoms of endometriosis, then surgery can be done to improve your chances of fertility. But this should be discussed with the doctor provided that it is a possible explanation of not conceiving. You can either have a laparoscopy or a laparotomy.
Note: It is not guaranteed that after surgery, endometriosis cannot reoccur. If it does, it doesn’t need to show symptoms. However, reoccurrence is about 50% over 5 years.
- IVF – Reproductive techniques such as In-Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI) are proven ways to treat infertility due to endometriosis.
Endometriosis occurs in 10% of women of the world and while it can get really painful, there are ways through which you can control its spread. However, most doctors advise their patients to get pregnant or freeze their eggs if they want to have children before it gets severe
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Dr. Jay Mehta
Fertility and IVF Specialist
Dr. Jay Mehta is the Scientific Director of Shree IVF Clinic. He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology.