Simple facts show that of women who are infertile about 50% have endometriosis, and of women with endometriosis about 50% of them will be infertile (statistics vary according to the study and exact stage of endometriosis).
Once a woman has been diagnosed with infertility, and no other explanation is the cause, then her fertility management includes looking for and the treatment of endometrosis.
Exactly why endometriosis causes infertility is not exactly known in every case. Endometriosis has been called an inflammatory condition which is caused by implants or lesions of uterine lining-like (endometrium-like) tissue outside of the uterus, usually on the ovary or near the ovary, or if there is tubal blockage then it is easy to understand why this is associated with infertility. But some women just have endometriosis implants that shouldn’t interfere with egg production or tubal function that are still associated with infertility.
The degree of inflammation in the pelvis due to endometriosis may be related to both the number and location of implants and the degree of infertility. Other causes discuss altered hormone and ovulation by an ovary affected by the endometriosis and even leading to defective numbers of eggs and embryos, as well as abnormal transport of the fertilized into the tube.
Correcting fertility which is impaired by endometriosis is almost as controversial. Much research states that ovulation induction, and management of that treatment is the most effective and quickest way to conceive. You have to have individual consultation to decide the best overall treatment for both endometriosis and infertility.
The more advanced the stage the more likely a woman is to be infertile, so these women probably want treatment of their endometriosis before trying to conceive. Then studies differ on whether to take medication or perform surgery.
As newer medications come on board this may change, but for now, for advanced cases of endometriosis medication, such as lupron which can drastically lower estrogen levels, may be beneficial, although some studies suggest surgery is associated with more rapid times to conception than medication. The other issue is whether you have a case of endometriosis that will progress if not treated.
Also endometriosis tends to be a progressive disease and 30-60% of patients will progress without treatment, and we cannot predict which patients will progress.
Then it’s time to gab with your gyno on what the best way to get pregnant will be. At Women’s Health Practice we are enrolling clinical research trials in endometriosis. Call