Why can’t I conceive?

Endometriosis is a common gynaecological condition that can affect about 10% of women. It is one of the most common causes of infertility. It is a condition where the lining of the uterus has grown outside the uterus causing scarring and adhesions.

Each time menses occurs the endometrial tissue deposits outside of the endometrium causing abnormal bleeding, bloating, bowel and bladder irritability. Some patients may have no symptoms. When the lining bleeds in the pelvis scarring and destruction of the tissue occurs. The endometriosis deposits spread and with time usually continues to get worse unless it is treated.

HOW DO I KNOW IF I HAVE ENDOMETRIOSIS?

Many women do not have any symptoms and may just present with infertility. Classical symptoms are:

• Period pain pre-period or during
• Back pain
• Bowel/bladder irritation
• Abnormal bleeding
• Bloating
• Pain with intercourse
• Nausea and vomiting/fainting at the time of period
• There have even reports of patients suffering from nose bleeds at the time of period as the tissue can spread (this is however very rare)
• Infertility

WHY DOES ENDOMETRIOSIS CAUSE INFERTILITY?

About 30-40% of women with endometriosis will present with infertility. Endometriosis can be very destructive and stick your pelvic organs together. The pelvic organs can also get stuck to the bowel and bladder. The delicate fallopian tubes may become damaged and blocked.

HOW IS ENDOMETRIOSIS DIAGNOSED?

If you suspect you have endometriosis and suffer infertility you should see a Doctor experienced in endometriosis and infertility. A pelvic ultrasound may diagnose endometriosis in some patients. In some cases of endometriosis ovarian cysts form and they are called endometriomas. The best way to diagnose endometriosis is to have a laparoscopy which is usually day surgery and can diagnose and treat endometriosis in most cases.

CAN ENDOMETRIOSIS BE TREATED?

Endometriosis can be treated both medically and surgically. Early diagnoses and treatment helps to prevent the disease from progressing.

WILL YOU NEED IVF?

Many women become pregnant after the endometriosis is treated by laparoscopy but if the endometriosis is very severe and has damaged the fallopian tubes then IVF may be required. If you are not trying to conceive it may also be worthwhile to discuss with your gynaecologist if fertility preservation is right for you as it may cause damage to your ovaries.