How Does Endometriosis Impact Fertility?
Endometriosis is a condition characterized by the growth of tissue similar to the uterine lining in areas outside the uterus. This tissue may invade the ovaries, fallopian tubes, bowel, bladder, pelvis, and abdomen. The misplaced tissue responds to hormonal changes during the menstrual cycle, causing inflammation, scarring, and often severe pain. Due to its effects on the reproductive system, endometriosis poses challenges to fertility. Here is how this condition impacts fertility in affected individuals:
Chronic Inflammation
When endometrial tissue grows in areas of the body where it is not supposed to, the immune system responds as if it were a virus or bacteria. Your body makes more immune cells to fight the foreign tissue. These cells release inflammatory cytokines, which increase blood flow to the affected area, causing inflammation. With invasive endometrial tissue, the body’s immune response causes inflammation. The high levels of inflammation may create a hostile environment in the uterus, which reduces the likelihood of implantation.
Anatomical Distortion
Severe peritoneal inflammation due to endometriosis can cause fibrous scar tissue to develop within the uterus, ovaries, and fallopian tubes. The scar tissue can affect parts of the reproductive organs, distorting their normal position and function. Blockage in the fallopian tubes may prevent the sperm from meeting the egg. Ovaries may develop endometriomas, cysts filled with old blood that interfere with ovulation. Extensive scarring in the uterus decreases the blood supply to the endometrium, making it difficult for a fertilized egg to implant.
Hormonal Imbalance
Excessive endometrial tissue growth causes a condition called estrogen dominance, where the body produces much higher levels of estrogen than progesterone. Elevated estrogen levels may cause anovulation, in which patients have their regular menstrual cycle but no ovulation. Without ovulation, there is no egg to fertilize, making conception impossible. Fluctuations in estrogen levels may also cause an irregular menstrual cycle, making it challenging to determine your fertile window.
Your reproductive system needs progesterone for a healthy uterine lining. Elevated levels may mean that you have lower progesterone levels, resulting in an insufficient uterine lining, which affects implantation. Estrogen dominance may also reduce the production of cervical mucus, making it harder for the sperm to move through the cervix to fertilize a mature egg.
Reduced Egg Quality
When you have endometriosis, the oxidative stress and inflammation effects gradually lower the quality of the ova, causing infertility. Because of scar tissue, the normal supply of oxygen and nutrients to the eggs gets altered. This causes inadequate maturation of the ova or eggs, leading to improper fertilization and infertility. Poor-quality eggs don’t mature into embryos even when fertilized, leading to early miscarriages. When endometrial tissue invades the ovaries, it may cause inflammation-related damage to healthy follicles, causing a decline in ovarian reserves.
Treating Endometriosis-related Infertility
If you have a history of severe pain during your menstrual period and are experiencing fertility challenges, it helps to get checked for an accurate diagnosis. After assessing your medical history, your fertility doctor may take a sample of your endometrial tissue and test for BCL6, a marker that identifies inflammation in the uterine lining. BCL6 tests are effective and can identify asymptomatic endometriosis.
Your fertility doctor can also perform imaging tests to check for endometrial lesions, adhesions, and ovarian endometriomas. After making a conclusive diagnosis, fertility doctors recommend medication, surgical intervention, or assisted reproductive technologies (ART) to treat endometriosis-related infertility.
Get a Comprehensive Endometriosis Diagnosis
Early diagnosis and personalized treatment plans are necessary for optimizing fertility for patients with endometriosis. Before attempting IVF or other fertility treatments, test for the presence of BCL6 markers to identify and treat silent endometriosis. Once you have your endometriosis symptoms under control, you can attempt ARTs with more confidence in a successful outcome. Get tested for endometriosis at a reputable facility today.
