Can endometriosis cause infertility?

By Cristiano Antonino On Mar 31, 2022

Endometriosis is a chronic benign condition caused by the development of endometrial cells in an ectopic location, i.e. outside the uterus, where they would normally reside

Endometriosis is therefore an exclusively female disease, affecting 10-20% of women of childbearing age

In some cases, the condition is suspected and diagnosed because of pelvic pain symptoms, but it is often diagnosed incidentally, as it is a silent condition in many cases.

It is also possible that some women only discover they have the condition when they experience fertility problems.

The condition is one of the possible causes of infertility.

Pain in the pelvis and during intercourse: symptoms of endometriosis

Endometriosis is often diagnosed late, as it is a complex disease which in its early stages is asymptomatic and only in its more advanced stages does it cause the patient pain which makes the disease suspicious.

The typical pain of endometriosis originates in the pelvic area and manifests itself particularly in the days around the menstrual cycle (pre- or post-menstrual pain, painful menstrual cycle).

Other symptoms associated with the disease are pain during sexual intercourse (dyspareunia), which significantly impairs the couple’s quality of life.

It is important to pay attention to the diagnosis of endometriosis and to visualise any ovarian cysts or other signs of pelvic endometriosis at an early stage.

In the most severe cases of endometriosis, ovarian cysts, including voluminous and/or bilateral ovarian cysts, and the formation of scar tissue and pelvic adhesions occur.

Endometriosis can be treated with drugs (the oestrogen pill, progesterone-only drugs, injections that suppress ovarian activity and induce a temporary menopause) or surgery.

Therapy should be modulated according to the severity of the condition and its associated symptoms.

The patient’s age and reproductive desire must also be taken into account.

It is therefore important to always refer to a gynaecological specialist and to get used to regular check-ups.

If the patient begins to experience pain, a gynaecological examination and transvaginal ultrasound are essential, especially if there is a desire to have children, as endometriosis is considered a risk factor for infertility in couples.

Endometriosis: Is it possible to get pregnant?

Diagnosis does not necessarily mean infertility.

There are many stories of women with endometriosis who have no problems conceiving, but it can be a risk factor.

The pathology can be localised in such a way as to affect the conception process.

As the disease progresses, ovarian endometriomas or pelvic localisations of the disease can cause damage to the ovaries or tubes, preventing the regular processes of ovulation and fertilisation of the oocytes.

Endometriosis and pregnancy: a gynaecological examination is essential

Women with endometriosis who wish to become pregnant must therefore consult a specialist in order to undertake a diagnosis and treatment.

The specialist gynaecologist will set up the most suitable treatment for the individual patient (and obviously also taking into account couple discussions, with diagnostic courses on the male partner).

If surgical treatment is indicated, preference should always be given to minimally invasive surgery, which must safeguard the patient’s reproductive health and, in particular, must affect the woman’s ovarian reserve as little as possible.

Finally, it should be remembered that pregnancy itself is considered a ‘natural therapy’ for endometriosis.

During pregnancy, in fact, ovulation is suspended, interrupting the primary stimulus for the development of ectopic endometrial cells.

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