Many women with endometriosis experience pelvic or abdominal pain, particularly with their menstrual bleeding or with sex. Some women have no symptoms at all. Endometriosis typically results in a long-term inflammatory state within the pelvis. This inflammation is thought to damage eggs immediately after ovulation. In addition, endometriosis can cause scar tissue, which creates anatomic barriers for achieving pregnancy, including damage to the fallopian tubes and ovaries. Finally, some forms of endometriosis are associated with a host of hormone receptor irregularities that may even lead to abnormal bleeding patterns.
Our Viewpoint
Endometriosis is a complex disease process with many different clinical presentations. We understand that the inability to conceive is correlated with short- and long-term ramifications of inflammation, immune system mediators, and mechanical changes, which can all result from endometriosis lesions. The Endometriosis Treatment Center of America recommends a full pelvic evaluation with the most minimally invasive method for all women who have documented unexplained infertility to investigate the possible etiology of endometriosis.
Relevance
If a patient has unexplained infertility, before beginning IVF or other modalities to promote conception, endometriosis should be considered as the possible etiology for their inability to conceive. If all conservative methods have been addressed, endometriosis should be evaluated with the most minimally invasive methods possible.
Clinical Data and Resources
- https://pubmed.ncbi.nlm.nih.gov/20801404/ (opens in new tab)
- https://pubmed.ncbi.nlm.nih.gov/26126067/ (opens in new tab)
- https://pubmed.ncbi.nlm.nih.gov/31091056/ (opens in new tab)
- https://pubmed.ncbi.nlm.nih.gov/29544710/ (opens in new tab)
- https://pubmed.ncbi.nlm.nih.gov/26395161/ (opens in new tab)
