Endometriosis And Infertility

Endometriosis is a cause of female infertility. The condition arises when endometrial tissue (the lining of the uterus) grows outside of the uterus and adheres to other organs in the abdominal cavity, such as the fallopian tubes and ovaries. The disease is progressive, in other words, it gets worse over time rather than better. It can also reoccur after it has been treated. Endometriosis can be accompanied by painful menstrual periods, abnormal bleeding, and pain either during or after intercourse. Yet, nearly one third of women with endometriosis have no symptoms other than infertility.

What Is Endometriosis?

Endometrial tissue that has attached outside of the uterus reacts exactly the same way to menstrual cycle hormones as the uterus does. That means that when the new cycle is about to begin, it swells, thickens and sloughs in preparation for the next cycle. The problem is that there is nowhere for the blood and tissue to go when it is outside of the uterus. Consequently, it pools in the abdominal cavity where it causes inflammation that becomes scar tissue. This scar tissue can block fallopian tubes and smother ovaries, causing interruption in ovulation. Cysts can form as well, which also interfere with ovulation.

Infertility Is A Common Result

More than five million American women are affected with endometriosis and of that number, between 30 and 40 percent are infertile. This rate is three times the rate of infertility in the general population. There is no one theory to explain endometriosis and there appears to be several possible causes. What is known is that for women who have endometriosis, the chance of conception decreases by 12 to 36 percent every month.

Women who have mild to moderate cases of endometriosis may conceive a pregnancy, but often suffer spontaneous abortion. Ectopic pregnancies are another common danger for women with endometriosis, who are up to 16 times more likely to have a tubal pregnancy that the normal population.

Luteal Phase Defect And Endometriosis

Luteal phase defect (LPD) is another problem inherent in endometriosis. When the luteal phase of the menstrual cycle is affected, as is common in women with endometriosis, then the timing of the release of the egg is affected. The luteal phase is the amount of time during the menstrual cycle between ovulation and the beginning of the next menstrual period. In normal cases, the period of time is 10 to 14 days. When the luteal phase is outside these parameters, then the woman has luteal phase defect-something that happens frequently with endometriosis. If the egg is not released at the correct time, then it cannot be fertilized and the woman is rendered infertile as a result.

In cases of luteal phase defect, the endometrium has not had adequate time to prepare for an egg to implant and, if a fertilized egg makes it to the uterus, the woman often aborts without ever knowing she is pregnant. Endometriosis disrupts the luteal phase of the menstrual cycle, which means that if a woman wants to have a baby, endometriosis must be treated and intervention by way of assisted reproduction is usually needed.

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