Fertility and Endometriosis

Endometriosis is defined as the presence of endometrial-like tissue in the space outside the uterus. It is a common and sometimes (very) painful condition.  It affects around one in ten women during their reproductive years.

Endometriosis can be difficult to diagnose.  It has similar symptoms to other conditions such as irritable bowel syndrome.

Endometriosis is a known cause of infertility, but there is hope. Dr Flynn has helped countless women with endometriosis become mothers.

What Causes Endometriosis

Endometriosis occurs when the tissue lining the inside of the uterus (endometrium) grows in areas of your body where it doesn’t belong. This can be on the ovaries, fallopian tubes, outside the uterus, bowel, bladder and rectum. Adenomyosis is similar tissue within the muscle/body of the uterus.

This rogue endometrium tissue still acts the same as the lining found in your uterus, and each month it also responds to hormonal changes.  During your period, the tissue breaks down, with inflammation in the surrounding area.  This causes heavy periods and associated infertility.  It can lead to organs sticking together (adhesions) and scarring within the pelvis.

Endometriosis can be frustrating and challenging to live with, affecting many aspects of daily life.

Symptoms Of Endometriosis

Confusingly, Endometriosis can cause a wide range of symptoms, or none at all.

One woman may experience severe pain and heavy bleeding with minimal endometriosis implants.  Another woman might have lots of endometriosis tissue, but no symptoms.

Pain is the most common symptom of endometriosis. Many women become aware that something is ‘not right’ when they ovulate, or get their period.  For many, this results in pelvic, abdominal or back pain.

In other cases, they can experience pain during sexual intercourse.

If the endometriosis has spread onto the bladder or bowel, there can be bleeding or discomfort, or irregular bowel activity.  There can be pain going to the toilet, or passing wind.

Menstruation with endometriosis can also differ between women. Heavy bleeding; irregular bleeding; prolonged periods; and spotting before a period are all typical symptoms.

Ultrasound or MRI investigations will often give a diagnosis of Adenomyosis. This should be seen as the same family as endometriosis and also causes fertility problems.

All these symptoms can contribute to fertility issues.

How Does Endometriosis affect Fertility?

A woman might not even be aware of any problem until she has difficulty becoming pregnant.  Endometriosis can be a cause of period dysfunction and irregularity.  This can make it difficult to know when you are ovulating.

If the fallopian tubes are damaged, or have scar tissue this can impede the flow of the egg down the tube. It could also make it difficult for the sperm to travel along the tube to fertilise the egg.

Endometriosis found on the ovary can form cysts, known as ‘endometriomas’.  During a period the cysts bleed, but the fluids cannot drain away.  The blood develops a thick chocolate appearance. These cysts are known as ‘chocolate cysts’ and can affect ovulation.

Endometriosis can also affect fertility by producing toxins which affect the sperm.  If conception does occur, endometriosis cells can produce chemicals which interfere with the possible implantation of embryo in the uterus.

The good news is that it’s possible to become pregnant when you have endometriosis, but some may need medical assistance to conceive.

Is there a treatment option for endometriosis?

I consider Laparoscopic surgery to be the best treatment for most cases of endometriosis, and it has a high success rate among our patients.

Laparoscopic surgery, also known as keyhole surgery, provides a definitive diagnosis and a treatment at the same time.

During a laparoscopy, Dr Flynn would identify the affected areas, and remove the endometriosis, scar tissue and adhesions. Any ‘chocolate cysts’ would also be removed. At the same time, the fallopian tubes and cavity of the uterus are checked.

The minimally invasive surgery results in reduced symptoms and improved chances of pregnancy.

Pregnancy can relieve the symptoms of endometriosis, because you are no longer menstruating, but it is not a cure.  Breast feeding also decreases symptoms for some time after birth.

Getting Pregnant with Endometriosis

Adhesions, cysts and scarring can affect the function of the reproductive system.  People having trouble conceiving can benefit from Assisted Reproductive Technology (ART). For people with damaged fallopian tubes, the most common ART procedure is in-vitro fertilisation (IVF).

IVF is generally used after laparoscopic surgery to remove endometriosis.  The optimal period for falling pregnant is between two months to one year after surgery.

Endometriosis can be extremely challenging, and especially when it affects your fertility.  It is important you ask for support when you need it.

Dr Flynn has extensive expertise in fertility and endometriosis.  He will help you gain control of your life by creating an individualised plan to effectively manage and treat your symptoms.