Endometriosis and Infertility

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Medical Contribution By Dr. Naveed Khan

Nearly 5.5 millions women in the U.S. today are dealing with the most common gynecological disease – Endometriosis. While a third of these women will be symptom free and never know they have the disease, many deal on a regular basis with painful and heavy periods, pelvic pain, urinary and GI problem, and, in some cases, infertility.

How Can Endometriosis Cause Infertility?

Endometriosis is a condition in which the tissue that lines the inside of the uterus, the endometrium, grows outside the uterus and attaches to other organs in the pelvis such as the ovaries and fallopian tubes. This tissue responds to your menstrual cycle hormones by swelling and thickening and then shedding to mark the beginning of the next cycle.

While the blood shed from the uterus during a period is discharged, the blood shed by grown endometrial tissue remains in the pelvis and can become scar tissue. This scar tissue can grow to block the fallopian tubes and interfere with ovulation.

Additionally, endometrial tissue that spreads to and grows inside the ovaries may form a type of ovarian cyst called an endometrioma which may also interfere with ovulation.

“Women who have endometriosis and whose primary concern is fertility, sometimes need to be referred by their Ob/Gyn to a fertility specialist who is able to treat the subfertility aggressively with superovulation and assisted reproductive technologies,” said Dr. Naveed Khan of Shady Grove Fertility’s Leesburg, VA office.

Timing Is Key

Endometriosis is a disease that, as it progresses, can significantly increase the risk of infertility, so doctors may advise newly diagnosed patients not to delay in trying to conceive.

“Endometriosis can get worse with time,” said Dr. Khan. “The longer a woman has endometriosis the greater her chances are of becoming infertile.”

While diagnosis can be suspected through patient history and/or a physical exam, Dr. Khan says that the most reliable way to know if a patient has endometriosis is via laparoscopy.

Endometriosis is classified in four different stages: minimal (stage 1), mild (stage 2), moderate (stage 3), or extensive (stage 4). These stages are based on the amount of scarred and diseased tissue found, and are important in determining which treatment option is best.

“Women with any stage of endometriosis can theoretically conceive on their own as long their tubes aren't blocked or the ends of the tubes aren't scarred and damaged,” said Dr. Khan. “If a woman is struggling to conceive on her own, then treatment options can range from low tech options such as superovulation with Intrauterine Insemination (IUI) to high-tech like IVF. We always work with our patients individually to determine and recommend the proper treatment option that’s right for them.”

To learn more about how Shady Grove Fertility can help you if you have endometriosis or to schedule an appointment with one of our physicians, please call 888-761-1967 to speak with one of our patient liaisons.

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