Endometriosis occurs when tissue similar to the inner lining of the uterus grows outside the uterus. In addition to growing on the bladder, bowel, and lower intestines, endometrial-like tissue can also grow on the ovaries and fallopian tubes, making it more difficult, but not impossible, for women with endometriosis to get pregnant.
Join us as we discuss the link between endometriosis and infertility and explain how you can improve your chances of getting pregnant naturally with endometriosis.
What Is Endometriosis?
The endometrium is the inner lining of the uterus (womb) where fertilized eggs are implanted for gestation and growth. Each month, increased estrogen levels encourage the endometrium to thicken in preparation for the gestation of a fertilized egg. When fertilization does not occur, the endometrium is designed to bleed and exit the body via monthly menstruation.
When endometriosis occurs, endometrial-like tissue begins to grow on pelvic organs outside the uterus and it tends to behave in the same way as the endometrium – thickening before ovulation and breaking down during menstruation.
The endometrial-like tissue does not leave the body like the endometrium. Instead, it can cause inflammation, pain, and endometrial growths on pelvic organs like the bladder, bowel, fallopian tubes, and ovaries.
How to Know If You Have Endometriosis?
The only sure way to know if you have endometriosis is to undergo a surgical procedure called a laparoscopy, which involves locating endometrial growths with a microscopic camera. That said, even though endometriosis is symptomless for some, the majority of women with the condition will notice some obvious indicators that something is not right in the pelvic area.
Depending on how long you’ve had the condition, as well as the location and depth of endometrial growths, symptoms of endometriosis can range from mild to severe, but generally include the following:
Chronic pelvic pain, abdominal discomfort, dysmenorrhea (heavy and painful periods), and dyspareunia (pain during sex) are common symptoms of endometriosis. Collectively, these symptoms can also affect a woman’s overall happiness and quality of life.
Because endometrial-like tissue can grow on the bowel and bladder, urinary incontinence and bowel issues can also occur. And 30-40% of women with endometriosis also find it difficult to conceive.
Does Endometriosis Cause Infertility?
Studies have concluded that endometriosis does not directly cause infertility, but it does result in fertility issues that make it more challenging to get pregnant.
For example, endometrial growths and scar tissue on or within the fallopian tubes can create blockages that prevent sperm from connecting with released eggs. The inflammation that occurs with the monthly breakdown of endometrial-like tissue also instigates the production of harmful molecules like cytokines, which can paralyze sperm and prevent fertilization.
Endometrial cysts on the ovaries, known as endometriomas, can slow the production of eggs as well as prevent them from being released. Endometrial growths like lesions, cysts, and adhesions (bands of tissue joining organs together that otherwise exist separately) can also change the anatomy of the pelvic area making it more challenging for sperm and eggs to connect.
How Female Hormones Are Affected by Endometriosis
Throughout each menstrual cycle, hormones like estrogen and progesterone naturally fluctuate to maintain a healthy reproductive system. With endometriosis, however, studies suggest that the natural fluctuation of female hormones is upset, possibly causing the production of too much estrogen and too little progesterone.
This type of disruption to the natural synchronization of the female reproductive hormones is also believed to contribute to the fertility issues experienced by women with endometriosis.
What is Adenomyosis?
Adenomyosis is another form of endometriosis that affects the muscular wall of the uterus. When misplaced endometrial-like tissue is found growing here, medical researchers believe that it can prevent the implantation of fertilized eggs and gestation. When adenomyosis occurs, women can also be more prone to miscarriages.
Can You Get Pregnant Naturally with Endometriosis?
Yes, even though women with endometriosis often turn to fertility treatments like IVF, female health experts have proven it is possible to get pregnant naturally by managing the underlying symptoms over the long term.
This generally revolves around relieving the chronic pelvic pain associated with endometriosis, reducing inflammation, making sex pain-free and pleasurable again, and managing the stress and anxiety that often go hand in hand with trying to get pregnant.
Conclusion
When it comes to endometriosis and infertility, it’s helpful to understand that endometriosis does not cause infertility, but it does make it more challenging to conceive. By addressing the underlying symptoms like pelvic pain, inflammation, discomfort during sex, stress, and incontinence, many women get pregnant naturally without the need for fertility treatments.
Incorporating a symptom management plan with the help of a physical therapist, nutritionist, and some at-home therapies can significantly help women with endometriosis get pregnant and carry their baby full term.
References
Endometriosis Foundation of America – Endometriosis Symptoms: Infertility - https://www.endofound.org/infertility
National Library of Medicine – Endometriosis and Infertility - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941592/
American Society of Reproductive Medicine – Endometriosis: Does it Cause Infertility - https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/endometriosis-does-it-cause-infertility/
National Library of Medicine - Endometriosis and Infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538128/
Endometriosis Foundation of America - Everything You Need to Know About Pelvic Floor Physical Therapy (PFPT) for Endometriosis - https://www.endofound.org/everything-you-need-to-know-about-pelvic-floor-physical-therapy-pfpt-for-endometriosis
National Library of Medicine - Nutrition in the prevention and treatment of endometriosis: A review - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9983692/