Is Endometriosis Causing My Infertility? How Do I Know I Have Endometriosis?

Signs and Symptoms of Endometriosis and How to Test For It

Whether you have it, have never heard of it, or are paranoid AF about what you've read on web forums about it, this post is for you. We checked out the most current peer-reviewed studies, articles, and stats on endometriosis to keep our TTC ladies informed.

BOTTOM LINE

Endometriosis is a factor for 25-50% of all women struggling with infertility, according to The American Society for Reproductive Medicine. It’s also an incredibly complex diagnosis, with no known causes of onset. Let’s looks at endometriosis purely through a fertility lens.

What is endometriosis?

Endometriosis occurs when tissue similar to the endometrium (the lining of the uterus) is found outside the uterus on other parts of the body, causing lesions. This is the tissue that should be released from your body during menstruation, but for whatever reason is left behind.

The primary reason for infertility as a result of endometriosis is the occurrence of internal scar tissue or adhesions, that prevent egg release and block sperm from entering the fallopian tubes.* Inflammation is another variable, creating a hostile environment for sperm, eggs, and possibly even the embryo.

How does it get there?

There is no known cause, but there are, however, some pretty sound theories of why endometriosis occurs. One universal thought is that during menstruation, menstrual tissue backs up into the Fallopian tubes, enters the abdominal cavity, and implants.** According to the Endometriosis Association, a majority of physicians believe that all women experience some type of this back up in their lives, but women who have immune problems go on to be at more risk for endometriosis.***

What could increase my chances of endometriosis?

Genetics, environmental factors (join the newsletter, we have an article coming out on more specifics), short menstrual cycles (less than 27 days) and premature menstruation in early years, can all be signs that you’re at risk. In fact, endometriosis can begin affecting girls as early as 7 years old.****

Symptoms and Diagnosis

The symptoms below generally go along with endometriosis, but cannot be relied upon to diagnose, as they’re generally pretty ordinary symptoms of, well, life. In fact, there is no home or even lab test for diagnosing endometriosis. The only way to verify the disease is to undergo an outpatient laparoscopy, with pathology confirmation of biopsy specimens.

So why even share these accompanying symptoms, and plant a seed of paranoia? Firstly, don’t even water that seed, girl, until you’ve discussed with your doctor if you’re experiencing any of the below symptoms without explanation:

• Intense menstrual cramps that don’t respond to NSAIDS (Naproxen, Ibuprofen). These would be described as handicapping; severity that keeps you from doing day to day activities
• Long periods (longer than 7 days)
• Heavy menstrual flow, that requires you to change your natural pad or tampon every 2-3 hours throughout your entire menstruation. Make sure you know what feminine products are safe for fertility!
• Bowel and urinary disorders. These could be including but not limited to painful urination or bowel movements, frequent urge to urinate, or diarrhea
• Nausea or vomiting
• Pain during sexual activities
• Infertility
• But also, remember that endometriosis can be totally silent as well

Treatment

There is no cure for endometriosis, but treatment can relieve symptoms and help with fertility.

Endometriosis varies in level of severity, as does the therapy needed to treat it. Patients experiencing moderate to severe endometriosis often do need surgical intervention to be able to conceive thereafter. Some have even claimed that pregnancy cures endometriosis, but it’s more likely that pregnancy reduces symptoms because of increased progesterone in the body.***

Conception After diagnosis and or treatment

Without treatment, it can be very difficult for couples to get pregnant. Infertility patients experiencing even mild endometriosis left untreated have a 2-4.5% rate of pregnancy per month compared to unaffected fertile couples who experience a 15-20% monthly pregnancy rate. If endometriosis is moderate to severe and left untreated, chances of conception are less than 2% per month.*

Treated endometriosis yields more optimistic numbers. In a recent study, natural conception rate was examined following laparoscopic surgery in infertile women with endometriosis. Pregnancy rate amounted to 41.9% within the first 12 months following surgery.**** BioMed International published a study subsequently that concluded that treatment for severe endometriosis in TTC women (but not necessarily infertile women) resulted in 73% chance of pregnancy if conception was attempted within a year of treatment.***** These pregnancies were a mix of natural and ART.

THE TAKEAWAY

With the causes of endometriosis still unknown, it's important to strive for reproductive as well as general wellness while TTC, and lessen your exposure to fertility killers. Talk to your doctor if you have any concerns about endometriosis, and remember that treatment greatly improves chances of pregnancy for both natural as well as ART conceptions following surgery.

Huddle time all. This topic deserves some serious XOXO.

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THE NITTY GRITTY

*http://www.huffingtonpost.com/entry/58ae4794e4b0d0d07e7c675c

**http://americanpregnancy.org/womens-health/endometriosis/

***http://www.endometriosisassn.org/endo.html

****http://wtop.com/center-for-innovative-gyn-care/2016/03/endometriosis-and-period-pain-redefining-normal-for-teenage-women/

****Lee, Hye Jun et al. “Natural Conception Rate Following Laparoscopic Surgery in Infertile Women with Endometriosis.” Clinical and Experimental Reproductive Medicine 40.1 (2013): 29–32. PMC. Web. 7 May 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630290/

******Nesbitt-Hawes, Erin M. et al. “The Surgical Treatment of Severe Endometriosis Positively Affects the Chance of Natural or Assisted Pregnancy Postoperatively.” BioMed Research International 2015 (2015): 438790. PMC. Web. 7 May 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4515280/