Endometriosis and Infertility

Key Points:

• Endometriosis can cause infertility in 30% to 50% of affected women due to pelvic distortion, adhesions and hormonal changes.
• Diagnosis of endometriosis involves various tests like pelvic exams, ultrasounds, MRIs and laparoscopy to identify physical signs of the condition.
• Treatment options for endometriosis-related infertility include intrauterine insemination (IUI), in vitro fertilization (IVF) and for those facing persistent challenges, surrogacy can offer an alternative pathway to parenthood involving a gestational carrier.

If you’ve been diagnosed with endometriosis, you’re likely familiar with the symptoms. If you and your partner have been trying to conceive and have been unsuccessful, this could be an indicator of another symptom: infertility.

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If you’re struggling with endometriosis and infertility or want to learn more about how endometriosis can cause infertility, keep reading.

Disclaimer: We are not medical professionals, and the advice we offer is not medically certified. You should always talk with your doctor for professional medical help.

What is Endometriosis?

Endometriosis is an often-painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus – the endometrium – grows outside your uterus.

Endometriosis most commonly involves the ovaries, fallopian tubes, and the tissue lining your pelvis. Rarely, endometrial-like tissue may be found beyond the area where pelvic organs are located.

With endometriosis, the endometrial-like tissue acts as endometrial tissue would, as it thickens, breaks down, and bleeds with each menstrual cycle. But because this tissue has no way to exit your body, it becomes trapped.

When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissues and adhesions – bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.

Does Endometriosis Cause Infertility?

If you have endometriosis, it may be more difficult for you to become pregnant. Up to 30% to 50% of women with endometriosis may experience infertility.

Endometriosis can influence fertility in several ways, such as:

• Distorted anatomy of the pelvis
• Adhesions
• Scarred fallopian tubes
• Inflammation of the pelvic structures
• Altered immune system functioning
• Changes in the hormonal environment of the eggs
• And more

For pregnancy to occur, an egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development.

Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as by damaging the sperm or egg.

Even so, many with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise those with endometriosis not to delay having children because the condition may worsen with time.

How is Endometriosis Diagnosed?

To diagnose endometriosis and other conditions that cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.

Tests to check for physical cues of endometriosis include:

• Pelvic Exam: Your doctor feels areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus.
• Ultrasound: This test uses high-frequency sound waves to create images of the inside of your body.
• Magnetic Resonance Imaging (MRI): This is an exam that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body.
• Laparoscopy: The main way to tell for certain if you have endometriosis is through a surgical procedure called laparoscopy, which allows the surgeon to view inside your abdomen to look for signs of endometrial tissue outside the uterus.

Are There Endometriosis Infertility Treatments?

If you have or suspect that you have endometriosis and are having trouble getting pregnant, you may want to seek the help of a fertility specialist.

Your doctor may recommend trying intrauterine insemination (IUI) or in vitro fertilization (IVF), as both are assistive reproductive technologies.

Intrauterine Insemination (IUI)

This fertility treatment is a cost-effective and simple procedure, involving sperm being inserted directly into the uterus. This procedure requires no recovery time and is generally done in a doctor’s office.

Many people who do the IUI procedure take certain fertility medications in the weeks leading up to the procedure. These medications will raise estrogen levels, so it’s possible that your endometriosis pain might increase temporarily.

In Vitro Fertilization (IVF)

This fertility treatment is a more advanced form of assisted reproductive technology. The first step involves taking hormonal medications that help stimulate the ovaries to produce eggs. Using blood tests and ultrasounds, your doctor is able to monitor how your body responds to the medications and the growth of your eggs.

After the eggs are removed from the ovaries during an egg retrieval procedure, they are taken to a lab to be mixed with sperm to create embryos. Once the embryos mature and are ready, they can be transferred into the uterus or frozen until a later date.

Are There Other Options? [Surrogacy Could Be Right for You]

For those who are still struggling with infertility through their endometriosis, or for any other reason, another option is through surrogacy. This ART method allows intended parents to have a genetically-related child but they don’t carry the baby to term themselves.

Surrogacy combines IVF and a gestational carrier to bring a child into the intended parents’ lives. During this process, intended parents create an embryo either on their own or through a donation process. The embryo is transferred into another woman’s uterus, where it will develop until she gives birth.

Surrogacy is a partnership, as the intended parents and surrogate will be there to support each other throughout the process, and their surrogacy professional helping mediate and provide any resources that are needed.

Although surrogacy does provide the genetic relationship many intended parents are looking for, it’s also an emotional process. Grieving the loss of the pregnancy experience can take a lot of time for parents, so it’s important that they work through those emotions before moving forward to prevent any hostile feelings towards their surrogate during this intimate relationship.

Despite the potential difficulties and emotions, many intended parents and surrogates who complete this process find it a fulfilling, beautiful one they treasure for the rest of their lives.

Surrogacy is not a decision that you have to make overnight, and it shouldn’t be made quickly either. Doing research to understand what surrogacy is, what it involves, and what it costs can help you get a better idea of whether surrogacy is a good path for you.

Talking with a surrogacy professional or contacting a surrogacy agency can also help answer any questions you have and get you information you need to decide if surrogacy is the right option for you. You also never have to rush to make a decision on surrogacy; it will always be available to you.

If you’d like to learn about surrogacy and how it can be a great option for you, especially if you’re struggling with endometriosis and/or infertility, you can reach out to speak with a surrogacy professional.