The Impact of Endometriosis on Fertility: Understanding the Connection

Published: 05/06/2023

What is the impact of endometriosis on fertility?

What is endometriosis?

Endometriosis is a common yet often misunderstood condition that affects millions of women worldwide. It occurs when tissue similar to the lining of the uterus, known as the endometrium, grows outside the uterus, commonly in the pelvic area.

Endometriosis is a long-term chronic condition that can cause a variety of symptoms (discussed below) and make it harder to get pregnant. It can affect 1 in 10 women so it is even more important to raise awareness and education around it. 

You are more likely to get endometriosis if you: 

  • Smoke
  • Have a mother or sister who has it (genetic)
  • Have a low body mass index
  • Went through puberty early (before the age of 11 years) 
  • Have not been pregnant before 

If you have access to myTamarin support through your employer we have a range of women's health nurses available to discuss any questions, or concerns you are having. 

What are the causes of endometriosis?

Endometriosis is a complex condition, and its exact causes remain unknown. There have been a few suggested causes including:

  1. Genetics -  research indicates that there may be a genetic component involved, as endometriosis tends to run in families. Certain gene mutations may make some women more susceptible to the condition.
  2. Retrograde Menstruation: where the womb lining, instead of shedding out of the vagina, flows backwards into the fallopian tube and abdomen, allowing the endometrial tissue to implant and grow in areas outside the uterus.
  3. Endometrium cells spreading through the body in the blood stream or lymphatic system.
  4. A problem with the immune system 

What are common symptoms of endometriosis?

The symptoms of endometriosis can vary hugely - some women may experience severe, debilitating symptoms and some might have none at all. 

Common symptoms of endometriosis include:

  • Pain in lower stomach or back 
  • Debilitating period pain 
  • Deep pain during or after sex 
  • Pain when using the toilet during your period 
  • Heavy periods 
  • Infertility

Are there any cures for endometriosis?

There's not a  cure for endometriosis and it can be difficult to treat. Treatment aims to ease symptoms so the condition does not interfere with your daily life.

Treatments include:

  • painkillers – such as ibuprofen and paracetamol
  • hormone medicines and contraceptives – including the combined pill, the contraceptive patch, an intrauterine system (IUS), and medicines called gonadotrophin-releasing hormone (GnRH) analogues
  • surgery to cut away patches of endometriosis tissue
  • operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy)
  • alternative therapies: such as herbal remedies, acupuncture, and dietary changes

It's important for an individual to speak with a healthcare professional for guidance on the best symptom management for them. Having access to fertility, and health experts through myTamarin provides people with support during this difficult time. 

The connection with endometriosis and fertility

Endometriosis can affect fertility as these tissues can deposit themselves on the ovaries and fallopian tubes, causing fallopian tubes to become blocked and result in trouble with ovarian function such as lack of ovulation. This then leads to irregular periods which can it make it difficult to know when you are more likely to get pregnant. 

The National institute of clinical excellence and care (NICE) recommends that you should be offered IVF if you have mild endometriosis and have been trying to get pregnant naturally for 2 years.

Those with moderate to severe endometriosis have a lower chance of getting pregnant with IVF. If you have been diagnosed with endometriosis and are due to have surgery, then the recommendation from the consultant could be to egg freeze or embryo freeze before the surgery just in case it does not go as planned. 

There has been some evidence to suggest that having endometriosis increases risk of placenta previa (this is when the placenta attaches lower down in the womb and covers the cervix). Evidence also has found that if you have endometriosis there is an increased risk of an ectopic pregnancy.

While endometriosis can pose challenges to fertility, various treatment options are available to manage the condition and improve the chances of conceiving. Medical management, surgical intervention, and assisted reproductive technologies like IVF and IUI can help individuals with endometriosis fulfil their desire to become parents

Because the symptoms vary so much, it's extremely important for individuals to consult professionals when they are looking for further information around fertility treatment with endometriosis. 

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