Understanding Endometriosis

Endometriosis is a condition that affects 1 in 8 individuals with a uterus in the United States, yet it remains underdiagnosed and misunderstood. At Boston IVF, we see many patients struggling with pelvic pain, difficulty conceiving, and other symptoms related to this condition. Here’s an overview of what you should know about endometriosis and how it impacts fertility.

1. What is Endometriosis?
Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus, often on the ovaries, fallopian tubes, and other pelvic organs. These tissue patches react to menstrual cycles just like the uterine lining—thickening, breaking down, and bleeding—but since they are outside the uterus, they have no way to exit the body, leading to pain, inflammation, and scarring.

2. Common Symptoms
Symptoms of endometriosis can vary widely and may include:

• Painful periods (dysmenorrhea) severe enough to interfere with daily activities.
• Pain during intercourse.
• Pain with bowel movements or urination, particularly during menstrual periods.
• Chronic pelvic pain.
• Heavy menstrual bleeding or bleeding between periods.
• Difficulty conceiving.

While these symptoms can overlap with other conditions, they often worsen over time, which is why early diagnosis and treatment are crucial.

3. How is Endometriosis Diagnosed?
Diagnosing endometriosis typically starts with a thorough medical history and physical exam, often followed by ultrasound imaging. However, the most definitive way to diagnose endometriosis is through laparoscopy, a minimally invasive surgery in which a camera is inserted into the pelvic cavity to visualize the presence of endometrial-like tissue.

During a laparoscopy, surgeons can also remove or excise the abnormal tissue, which can relieve pain and improve fertility outcomes.

4. Impact on Fertility
Endometriosis can affect fertility in multiple ways:

• Inflammation and scarring can interfere with the function of the ovaries, fallopian tubes, and uterus, making it harder for eggs to be fertilized or for embryos to implant.
• Ovarian endometriomas, also known as “chocolate cysts,” can damage ovarian tissue and reduce ovarian reserve.

That said, many people with endometriosis can still conceive naturally, especially with early diagnosis and treatment. However, if pregnancy does not occur after a reasonable time trying, fertility treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be recommended.

5. Treatment Options
Endometriosis treatment depends on the severity of the condition, symptoms, and whether the patient is trying to conceive. Treatment options include:

• Pain management: Over-the-counter pain relievers, hormonal birth control, or other medications can manage symptoms.
• Surgical intervention: Laparoscopic excision surgery can remove endometrial tissue, reduce pain, and improve fertility.
• Fertility treatments: If surgery alone does not improve fertility, assisted reproductive technologies like IVF may be considered.

At Boston IVF, we tailor endometriosis treatment plans to each patient’s unique situation. Sometimes, addressing endometriosis before fertility treatments like IVF or IUI can improve the chances of a successful pregnancy.

6. Can Endometriosis Return After Treatment?
Endometriosis is considered a chronic condition, and while excision surgery can significantly reduce symptoms, there is a chance that the disease may return. However, the majority of patients experience significant relief after surgery, and many are able to conceive following treatment.

7. Endometriosis vs. Adenomyosis
Adenomyosis is a condition where endometrial-like tissue grows into the muscular walls of the uterus, causing heavy periods and pain. While the two conditions share similarities, they are distinct diseases. Adenomyosis is often treated with medical management, while endometriosis may require surgical intervention. In some cases, both conditions can coexist, further complicating symptoms and treatment.

8. Support at Boston IVF
Whether you are seeking relief from pain, trying to conceive, or both, Boston IVF is here to provide expert care and personalized treatment. Our team of reproductive endocrinologists and surgeons is dedicated to helping individuals with endometriosis not only manage symptoms but also achieve their family-building goals.

If you suspect you have endometriosis or have been recently diagnosed, contact us to schedule a consultation. We are here to help you on your journey to better health and fertility.