EndometriosisWhat is endometriosis?

Endometriosis is a medical condition when cells lining the uterine cavity (endometrium) grow inside the abdomen. These lesions from endometriosis are non-cancerous, but can cause many problems such as pelvic pain and infertility. Endometriosis is most commonly seen on the tissue lining the abdomen (peritoneum), ovaries, fallopian tubes, bladder, and even the bowel. When endometriosis grows on the ovary, it can form a cyst referred to as an endometrioma or “chocolate-filled” cyst. Endometriosis is usually diagnosed in women between the ages of 25 to 35. The causes of endometriosis are still unknown, however several theories exist. Women who have endometriosis often have a close family member (mother or sister) with the same diagnosis.

How is endometriosis diagnosed?

Endometriosis can be difficult to diagnose. Patients usually suffer from chronic pelvic pain. This pain can vary significantly from one person to another. Common symptoms include: severe pain with menstrual cycles, pain during or after intercourse, cyclical pain throughout the month, and sometimes associated with infertility. Unfortunately, the only way to know for sure if a patient has endometriosis is to perform a minimally invasive surgery known as laparoscopy or robotic surgery. During surgery, the abdomen can be inspected visually and any suspicious areas are typically biopsied and examined under a microscope. Endometriosis generally can not be diagnosed from imaging techniques such as an ultrasound, CT scan or MRI. At Dallas-Fort Worth Fertility Associates, all of our physicians have undergone specialized training to be able to diagnose and treat endometriosis for their patients.

Can endometriosis cause infertility?

Endometriosis is associated with infertility for many women. Research has shown that women with untreated endometriosis have a decreased ability to get pregnant. Endometriosis can influence fertility in several ways: distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, changes in hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality. According to the National Institutes of Health, at least 5.5 million women in North America have endometriosis and 30 to 40 percent are infertile. Fortunately, with the help of an infertility specialist, most women with endometriosis are able to get pregnant and carry a pregnancy.

What is the treatment for endometriosis?

Although there is no cure for endometriosis, medications or surgery are available to manage pain and infertility associated with this medical condition. The approach that you and your doctor will choose depends on the severity of your symptoms and whether you hope to become pregnant. Over the counter medications such as ibuprofen, naproxen or acetaminophen may be recommended by your doctor. Physicians specialized in fertility should be consulted prior to surgery for women with endometriosis.

What is the surgical staging of endometriosis?

At the time of your surgery your doctor will evaluate the amount, location, and depth of endometriosis and give you a “score.” This score will determine whether your endometriosis is considered minimal (Stage 1), mild (Stage 2), moderate (Stage 3), or severe (Stage 4). The scoring system correlates to pregnancy success. Your doctor will also surgically destroy or remove the endometriosis and any scar tissue. This treatment will help to restore your normal anatomy and will allow the reproductive organs to function more normally. Your chances of becoming pregnant should improve especially if you are in the moderate to severe range. An entire infertility evaluation is recommended before considering treatment for endometriosis, as treatment is individualized for each patient.