Causes of Infertility in Endometriosis

Written by Zhang Lu
Obstetrics
Updated on September 07, 2024
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Endometriosis is a common gynecological disease that severely troubles women's daily lives. Besides causing painful menstruation, endometriosis is also a common cause of infertility. The reasons for infertility caused by endometriosis include the following aspects:

First, endometriosis often leads to the formation of chocolate cysts on the ovaries, which can affect ovarian function and cause impaired ovarian function.

Second, endometriosis can sometimes affect the function of the fallopian tubes, causing adhesions in the fallopian tubes. This may result in difficulties in egg pickup, preventing the sperm and egg from meeting and forming a fertilized egg in the fallopian tubes, leading to infertility.

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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 Li Shun Hua
Obstetrics and Gynecology
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How is endometriosis treated?

The treatment methods for endometriosis depend on the patient's age, the severity of symptoms, and whether they have childbearing requirements. For younger patients who wish to have children, conservative treatment methods are preferable, followed by ovulation induction therapy. For older patients with more severe symptoms, surgical treatment may be considered. If the patient does not have immediate childbearing requirements, a hormonal intrauterine device (IUD) can be placed in the uterus. This device releases progesterone and provides excellent treatment results for endometriosis. If the symptoms of endometriosis are severe, manifesting in pronounced dysmenorrhea, excessive menstrual bleeding, or ovarian cysts, then surgical treatment should be considered.

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Written by Yue Hua
Obstetrics and Gynecology
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Does endometriosis need treatment?

Whether or not endometriosis requires treatment entirely depends on the patient's symptoms. If it is a mild case of endometriosis without severe symptoms, the patient can undergo regular follow-up visits. However, if the patient experiences severe abdominal pain during menstruation, it depends on whether the patient has reproductive demands. If there are reproductive demands, medication can be administered; clinically, high-dose progestogens are commonly used to prevent the ectopic endometrial tissue from continuing to grow. If the patient has no desire for childbirth and suffers from severe pain, a hysterectomy and bilateral adnexectomy may be performed.

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Obstetrics and Gynecology
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Does endometriosis require the removal of the uterus?

Endometrial displacement, depending on the specific location of the displacement, calls for different treatments. When the endometrial glands and stroma invade the myometrium, it is called adenomyosis. Treatment is based on the patient's symptoms, age, and fertility requirements. If there are fertility requirements, or the patient is near menopause, medicinal treatment can be tried to alleviate symptoms. For younger patients with adenomyosis who have reproductive needs, focal excision surgery can be considered. For patients with severe symptoms, who either have no reproductive needs or for whom medicinal treatment is ineffective, a total hysterectomy may be considered.

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Written by Yue Hua
Obstetrics and Gynecology
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Consequences of Endometriosis

The consequences of endometriosis primarily include abnormal menstruation and infertility, with about 50% of those affected experiencing infertility. The reasons for this stem from the abnormal pelvic structures caused by endometriosis, as well as extensive adhesions of the fallopian tubes and ovaries, and abnormal motility of the fallopian tubes, all of which lead to reduced functions in transporting sperm and eggs. Furthermore, changes in the microenvironment within the pelvis also lead to infertility. Abnormal menstruation is mainly characterized by an increased amount of menstrual flow and prolonged menstrual periods, which can easily lead to anemia in patients.