Endometriosis is an extremely common disease that affects millions of women every year. It is estimated that over 190 million women globally have this condition, yet many remain unaware of it. This is because the symptoms are very similar to other conditions and often go unnoticed. Endometriosis is a disease where endometrial tissue grows outside the uterine cavity and into other organs such as the bowel, bladder, ovaries, and fallopian tubes. It causes pain in the pelvic region and causes infertility. 

Here are a few effects that endometriosis can have on a woman’s fertility-

‍

1. Distorts anatomy of the pelvis

If an area of endometrial tissue grows abnormally in another part of the body, this can cause symptoms such as pain and inflammation. If this happens too much or for long enough, it can cause scarring and damage to surrounding organs. This may lead to infertility if scar tissue interferes with ovulation or prevents sperm from getting into an egg or prevents implantation of an embryo in the uterus.

‍

2. Causes Adhesions

Endometrial tissues may bleed into the surrounding tissue, triggering an inflammatory response that results in the creation of a band between two organs called adhesions. Different types of adhesions associated with endometriosis exist (i.e. thin, filmy and transparent or thick, dense, and opaque). A lethal condition known as "frozen" pelvis may result from extensive adhesions within the pelvis.

‍

3. Scarred fallopian tubes

Endometriosis can block the fallopian tubes, which may prevent eggs from being released during ovulation, thereby contributing to infertility. However, if endometriosis does not directly block one or both fallopian tubes, it can still prevent sperm from reaching an egg and fertilizing it — leading to infertility as well.

‍

4. Inflammation of the pelvic structures

Endometriosis infections can cause inflammation throughout the pelvis and can lead to pain during intercourse and other symptoms of pelvic pain (such as bloating). If this happens, it can be difficult for women with endometriosis to conceive as they'll likely experience pain during intercourse or other sexual activity (and thus won't want to engage in it). Besides, the presence of ectopic endometrial tissue and resultant inflammation cause serious symptoms, including chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility

‍

5. Impaired implantation 

The endometrium, which lines the uterus, gets damaged during infection with endometriosis and changes its ability to implant into the uterine wall properly. This means that if a woman has endometriosis, she may have difficulty becoming pregnant because her body isn't able to create a healthy environment for a fetus.

‍

6. Altered egg quality

Infection with endometriosis can alter the quality of eggs. The resulting eggs may not be able to be fertilized by sperm, which means that a woman could experience reduced fertility. This happens because the egg is no longer able to develop properly after encountering an infection in the ovary or uterus.

‍

Infertility is a woman’s worst nightmare when she’s looking forward to motherhood. It can cause severe emotional and physical stress while having a negative impact on the relationship between her partner, her family, or even the society she lives in. Therefore, endometriosis should be taken care of, with a healthy diet, exercise, and well-balanced sleep. 

‍

References

• Bulletti, C., Coccia, M. E., Battistoni, S., & Borini, A. (2010). Endometriosis and infertility. Journal of assisted reproduction and genetics, 27(8), 441–447. https://doi.org/10.1007/s10815-010-9436-1
• Alimi, Y., Iwanaga, J., Loukas, M., & Tubbs, R. S. (2018). The Clinical Anatomy of Endometriosis: A Review. Cureus, 10(9), e3361. https://doi.org/10.7759/cureus.3361

‍