Does endometriosis cause infertility?

Written by Zhang Lu
Obstetrics
Updated on September 05, 2024
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Endometriosis is a common cause of infertility, primarily due to the ectopic implantation of endometrial tissue in the pelvic cavity or other locations. Endometriosis leads to infertility mainly because it affects ovarian function, such as causing ovulatory disorders. Additionally, endometriosis can cause pelvic adhesions, affecting the function of the fallopian tubes, such as their ability to pick up eggs. Women with infertility should be checked for endometriosis, and if confirmed, surgical or medicinal treatments can be considered to improve the condition and potentially increase the chances of conception. Therefore, endometriosis is a cause of infertility, and careful examination for endometriosis should be conducted in patients with infertility.

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Written by Yue Hua
Obstetrics and Gynecology
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How is endometriosis diagnosed?

Endometriosis is a condition where the uterine lining grows outside of the uterine cavity, commonly seen in the pelvic region, particularly above the ovaries. Therefore, ultrasound (B-ultrasound) examinations are primarily used for accuracy. The ultrasound may reveal a large mass on one side of the fallopian tubes or ovaries, with uneven content inside. During the ultrasound, it can also be observed that the capsule of the mass is intact. Additionally, during a gynecological examination, the doctor may also feel a mass in the adnexa.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How to treat endometriosis in the pelvic cavity?

When women suffer from pelvic endometriosis and the symptoms are not too severe—for instance, if the pain is relatively mild—they can be clinically observed during menstruation. If dysmenorrhea occurs, oral administration of non-steroidal anti-inflammatory drugs such as indomethacin can help alleviate the symptoms. However, some women may experience more severe symptoms and may require pseudopregnancy treatment with drugs, such as oral contraceptives or progestin-based medications. Another approach involves using GnRH analogues, a method known as 'medical oophorectomy.' If symptoms are severe and treatments are ineffective, surgical intervention might be considered. Surgical options include electrocoagulation of endometriotic lesions in the pelvis, sharp or blunt dissection of adhesions, which can also improve the pelvic environment and potentially enhance fertility in women. (Note: Medication should be taken under the guidance of a doctor.)

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Written by Li Shun Hua
Obstetrics and Gynecology
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Endometriosis characteristics

The main characteristic of endometriosis is painful menstruation, and in severe cases, it can lead to heavy periods and prolonged menstrual cycles. If endometriosis leads to the formation of ovarian chocolate cysts, the rupture of these cysts can cause severe abdominal pain. Moreover, endometriosis can easily lead to pelvic adhesions, which are a common cause of infertility. If the condition is severe, abdominal pain may also occur after the menstrual period has ended. In the case of adenomyosis, the symptoms include an enlarged uterine body, heavy periods, and prolonged menstrual cycles. If the condition is severe, then surgical treatment may be necessary.

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Written by Zhang Lu
Obstetrics
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What to do about dysmenorrhea caused by endometriosis?

There are two types of dysmenorrhea, primary dysmenorrhea and secondary dysmenorrhea. An important cause of secondary dysmenorrhea is endometriosis. The dysmenorrhea caused by endometriosis comes from specific diseases, and the interventions include the following aspects: First, symptomatic treatment should be conducted first, which means using pain relief medication to alleviate the pain. In clinical practice, various pain relief medications can be used for dysmenorrhea caused by endometriosis. Second, treatment should be aimed at the cause of the dysmenorrhea. Treatment for endometriosis currently includes both medicinal and surgical approaches. If surgical treatment is chosen, it can involve the removal of ectopic cysts or pelvic ectopic cysts, among other conditions; if medicinal treatment is chosen, methods such as pseudopregnancy or artificial menopause can be used.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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What tests are done for endometriosis?

For patients with endometriosis, it is recommended that you undergo a gynecological ultrasound examination to observe the condition of the ectopic endometrial tissue in the pelvic cavity, whether it is present on the uterus or ovaries, and whether it has grown on the abdominal wall. Therefore, it is advised to have a gynecological ultrasound examination and a gynecological exam. Patients with endometriosis can also have a blood test for tumor markers. If you wish to undergo additional tests, you can also have a cervical cancer screening, which is also possible. The main recommendations are the first three: the gynecological exam, gynecological ultrasound, and tumor marker tests. These examinations are advisable. If the endometriosis is very severe and the pain is quite intense, treatment may be necessary.