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 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 Zhang Xiu Rong
Obstetrics and Gynecology
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What tests are done for endometriosis?

Endometriosis is generally diagnosed through color ultrasound and CA-125 blood tests. If the endometrial tissue is located within the uterine muscle, it forms adenomyosis, at which point the ultrasound will show an enlarged uterus and uneven muscle wall echogenicity. Blood tests for the tumor marker CA-125, if elevated above the normal level of 35, generally indicate adenomyosis. If the endometrial tissue is located in the ovaries, it can form ovarian chocolate cysts, which are visible on the ultrasound as ovarian sections and echoes, with typical ultrasound reports indicating ovarian chocolate cysts. Therefore, routine examinations for endometriosis typically include color ultrasound and blood tests, which can confirm the diagnosis.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Endometriosis symptoms

When women suffer from endometriosis, the typical symptom is progressively worsening dysmenorrhea. What is progressively worsening dysmenorrhea? It is mainly because the ectopic endometrial tissue also becomes congested, swollen, and sheds each month during menstruation, causing the ectopic lesions to gradually enlarge, thus making the dysmenorrhea increasingly painful. Some women may have ovarian endometriomas or ectopic endometrial lesions in the posterior cul-de-sac of the vagina, which can also cause severe pain during intercourse. Ovarian endometriomas can also affect the normal ovulation of the ovaries, leading to menstrual cycle disorders, such as irregular menstruation or increased menstrual flow, among other phenomena. Endometriosis can also alter the pelvic environment, leading to difficulties in conception for women.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Does endometriosis hurt?

When a woman has endometriosis, she rarely experiences pain outside of her menstrual period, except in specific circumstances, such as during intercourse, where contact might be made with the ectopic endometrial lesions, causing severe pain, also known as dyspareunia. During menstruation, because the ectopic endometrial tissue is still active, it can undergo congestion, edema, rupture, and bleeding, leading to severe dysmenorrhea. Additionally, during the menstrual period, it can also cause an increase in prostaglandin secretion within the uterine cavity, enhancing the uterus's excitability, leading to dysmenorrhea.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Does endometriosis cause pain?

The clinical feature of endometriosis is painful menstruation, which tends to worsen over time. If the endometrial tissue is displaced to the ovaries, it can lead to the formation of ovarian endometriomas, often called "chocolate cysts", which can cause the ovaries not to release eggs and generally affects fertility. If endometrial tissue displaces to the uterus, it can cause adenomyosis, leading to a uniformly thickened uterine muscle layer and uneven muscle wall echoes, resulting in an enlarged uterus, which also impacts fertility. Therefore, it is crucial for patients with endometriosis to seek early treatment and prepare for pregnancy as soon as possible. Endometriosis, which affects fertility, is typically characterized by painful menstruation that gradually worsens, and generally, painkillers are insufficient for treating this condition.