Endometriosis is the gynecological condition where the cells that make up the lining of the uterus (endometrial cells) start to grow at sites other than the cavity of the uterus. Endometriosis and fertility are closely connected since this condition is one of the common underlying causes of infertility.
Endometriosis and fertility have a cause effect relationship since endometriosis is known to cause certain distortions in the reproductive anatomy of a woman. Also there could be fibrous growths called adhesions that develop as a result of trauma, previous surgery and so on, which prevent a pregnancy from occurring.
Endometriosis occurs when the endometrial cells, attach to other sites such as a woman’s ovaries, outer surface of intestines, fallopian tubes and the surface lining the pelvic cavity. Such growths or implants may also be found on the cervix, the vagina or the bladder; and less commonly outside the pelvis, on the liver, or in and around the brain or lungs (if the cells are transported to these organs by the lymphatic system of the blood stream) and on surgical scars.
Though it is quite likely that the endometriosis and its symptoms may themselves be responsible for a woman’s failure to get pregnant, there is another way in which endometriosis and fertility could be connected.
It could be that the same conditions that cause the endometriosis to occur could be the one’s responsible for a woman’s infertility as well. So a woman may fail to conceive for certain other reasons; that happen to be responsible for the abnormal endometrial growth as well.
A reported 25 to 50 per cent of women who complain of infertility are found to have endometriosis, so the connection between endometriosis and fertility is undeniable; even though it may be an indirect one. Though is not necessary that endometriosis will always prevent a pregnancy, it has been seen that among women who have endometriosis about 40 per cent are infertile as well.
In fact women who have mild endometriosis and normal anatomy are seen to have normal long term pregnancy rates. So infertility in women who have mild endometriosis seems not to be helped by treating the endometriosis of a woman, since in such cases there could be reasons other than endometriosis that causes the infertility.
There are many reasons why endometriosis and fertility have a cause effect or a coincidental relationship –
- Endometriosis causes anatomical abnormalities that prevent the normal process of the passage of the sperm, its union with the egg and the subsequent implantation of the embryo in the uterine walls. Interruption of any of these processes could mean prevention of a pregnancy.
- When the uterine lining is shed in an abnormal way (as in the case of endometriosis) this leads to tissue inflammation, scar tissue and adhesions that prevent pregnancy by trapping the ovaries, the fallopian tubes, uterus as well as the eggs themselves.
- In milder forms of the disease there could still be a connection between endometriosis and fertility since there could be hormonal interferences with the processes that facilitate pregnancy.