There can be a number of reasons that lead to infertility in women. Endometriosis is one of them. It is a benign condition where the endometrium, which includes the tissues that form the lining inside the uterus, grows outside the uterus. Apart from infertility, it may also cause pelvic pain in women.

There are no such symptoms of endometriosis apart from pelvic pain and it cannot be detected without surgery. Thus, it is very difficult to diagnose this disease and state how common it is. However, research says that the prevalence of this disease in women in their reproductive age is between 3 to 10 per cent.
It is found that endometriosis sometimes leads to infertility. Here is how:

Abdominal Adhesions and Infertility
Normally, the endometriosis implants develop in the abdomen. Then the body surrounds them with connective tissues. The reason for doing so is isolating the implants, so that they cannot harm your body.
Now, sometimes these adhesions can create a blockage in the opening of the fallopian tube or may also pinch off the fallopian tube. This will result in obstruction in the fertilisation of egg and the sperm and thus fertilization will not take place; so there are no chances of conceiving. These obstructions when diagnosed can be treated with surgery.

Secretions from implants
Endometrium plays a vital role in conception where the tissues secrete a wide variety of hormones and nutrients. Now, the endometrial implant also functions in the same way and secretes those hormones. The difference is that it does not deposit them in the lumen of the womb, and it is released in the abdominal cavity. In these substances, there may be some hormones that are responsible for infertility.

Prostaglandins
Prostaglandins are other hormones that are secreted by the endometrium normally. It helps in a lot of body processes that include various stages of menstrual cycle and pregnancy. This hormone is required for a lot of functions such as ovulation, sperm mobility, and regression of corpus luteum, immune interaction, menstrual cramps and contraction of the uterus at birth.

Just like the endometrium, the implants also secrete these hormones. And, the problem that is caused by the implant secreted prostaglandin hormone is that they are released in the abdomen and not in the womb. Moreover, they are not secreted at the right time, thus sending a wrong message to the brain.

A woman with a few days of pregnancy may face a miscarriage because the ovary will get a signal to start the menstrual cycle, and the womb lining where the egg is implanted will be expelled.

How Endometriosis Leads to Infertility and Miscarriages?

When tissues that usually grow inside the uterus, start growing outside the organ, it is called endometriosis. Painful periods, pain during sex, pain while urinating or bowel movements, extreme bleeding, fatigue, infertility, diarrhea, bloating and nausea are some of the symptoms of endometriosis.

Treating endometriosis usually depends on the following factors

Age
Severity of symptoms
Severity of the disease
Future plans for children
Depending on these the doctor might opt for any of the following treatments

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain killers like Nonsteroidal anti-inflammatory drugs. 
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may come back. Some of the hormone therapies include: 
Hormonal Contraceptives: Birth control pills, vaginal rings and patches are useful in controlling the hormones that are responsible for tissue build-up outside the uterine cavity. 
Medroxyprogesterone: This drug stops menstruation, which in turn stops the tissue build-up and put an end to all the symptoms. But on the other hand, gaining weight, low bone production and depression are some of the common effects of this drug. 
Gonadotropin-releasing hormone (Gn-RH) antagonists and agonists: Hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence prevent menstruation. 
Danazol: This drug prevents menstruation and symptoms of endometriosis by blocking the hormones that stimulate the ovaries. However, Danazol may not be a favourable option because of its side effects. The drug should be avoided during pregnancy.
Conservative Surgery: If you are trying to get pregnant, but you already suffer from endometriosis, then removing endometriosis surgically is a viable solution. Your uterus and ovaries will be preserved, which might increase your chances of becoming pregnant. Even suffering from severe pain might find relief from conservative surgery. 
Hysterectomy: In extreme cases, the only way to deal with the symptoms is to completely remove the uterus, ovaries and cervix. Since a hysterectomy means you cannot have children, it is kept as the last option for women in their reproductive age.

Management of Endometriosis

The woman s reproductive system is an extremely complex one. The uterus which is the main organ with its appendages helps in conception, pregnancy, and childbirth by undergoing marvellous changes. The uterus measures just about 7.5 x 4.5 in a normal woman and expands to accommodate a full-term baby within her during gestation.

The uterus is lined with smooth muscles, and due to unknown reasons, this lining material could be found in other parts of the pelvic organs. This condition is known as endometriosis and is one of the main causes of pelvic pain. Most women suffer through it, and it mostly gets diagnosed when some other issue is being investigated. 

For women with endometriosis, there are mainly two issues to deal with i.e. pain and depression.

Pain: While the pain per se is one issue, the way it affects daily normal life is another thing to be considered. For the pain to minimally affect routine life, the following are effective ways.

Exercise: Anything that you prefer like swimming, jogging, dancing, aerobics, cycling. This will help in stress management and pain relief.
Rest: Get adequate rest of 8 to 9 hours per night. On severely painful days, go ahead and sleep for a couple of hours extra.
Stress management: Whether through yoga or meditation or music, learn to manage stress better. Nobody is without stress but managing it is the key.
Eat healthy and fresh: Whole grains, fresh fruits and vegetables, increased fibres are definitely useful. Reduce whites including sugar, salt, and dairy products if possible.
Social life: Stay connected with people whose company you enjoy   be it family or friends, or even counsellor if required.
Speak up: Let your close circle of friends at work know your problem, so they can help when you need it the most.
Depression and mood swings can be managed in the following ways.

Do what makes you happy: There are some activities which will definitely make you feel better. A quiet walk to get some fresh air. Watching a dance video. Listening to your favourite soundtrack. Changing body language to one without stopped shoulders and frowning foreheads can make a big difference.
Focus on the good: Writing down or thinking about what went well for the day can cheer you up and overcome the blues that is so common in women with endometriosis.
Positive thinking: Instead of saying, I can not try saying I will try. It makes a BIG difference, and you will be amazed at the results.
Keep happy company near you: Surround yourself with happy, positive people and see your happiness quotient go up!!!
Endometriosis is definitely an enigma that is not well known, understood, or identified. However, the above are definitely useful way to cope with it.

Pain & Depression Due To Endometriosis - How To Deal With It? 

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus, the endometrium grows outside (endometrial implant). It commonly involves ovaries, bowel or tissues lining your pelvis. The main symptoms are pelvic pain and infertility. While chronic pain exists throughout, it tends to aggravate during menstruation and / or sex. Though the cause is not entirely clear, women with a family history of the condition need to be extra cautious. Endometriosis is normally detected by its symptoms combined with a medical imaging. Though the growth is not generally cancerous, a biopsy is recommended to eliminate doubts. 

The condition of endometriosis is attached with social and psychological effects as it affects a woman's child bearing ability. Most minds race anxiously as to what the surgeon might find and will your body heal after the procedure. Here are some tips to prepare for your endometriosis laparoscopy

 Before the surgery: read up as much as possible about your condition and note down questions you want to ask your doctor. Get details about the entire procedure and how the doctor is treating your specific case. Having knowledge will help you stay calm and focused. Next, gear your home for the process. Stock your fridge with quick heat home made meals. It's best for you and the family to have healthy food than the store bought preservative laden food. Clean your home, change your sheets and purchase some loose fit clothing for later use. Last but not the least, stock up on some reading material that will come handy during your rest period. 
 On day of surgery: do not eat or drink anything from 12 midnight until the time of your surgery. You may also need the unpleasant enema procedure during your prep. Remove your nail polish and leave your jewellery, watch and valuables at home. Shower and get to the hospital early to get on with the forms you'll need to fill. The procedure requires anesthesia so do discuss your allergies or any concerns you may have with this aspect of the procedure. Once you are set with you iv and anesthesia, the doctor takes over to do what they do best cure you.
 The procedure: a small incision is made near the belly button and the abdomen is filled with co2 gas which lifts it away from other organs. During the laparoscopy, the doctor examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis'filled cysts, adhesions, and scarring. He may then remove the lesions to send to a lab for biopsy
 After surgery: you'll most likely wake up groggy in the recovery room after your surgery. You may feel some pain as you come around but if it's a day procedure, you'll be able to leave as soon as you feel ready. 

Although pregnancy may temporarily suppress the symptoms of endometriosis, it does not eradicate the disease. The symptoms will almost always return after the baby is born. If you are suffering from this painful condition and want to seek help, you can consult here.

How To Prepare For Your Endometriosis Laparoscopy

The uterine cavity has a tissue base that is known as the endometrium. When this endometrium spills over or spreads to the other parts of the reproductive organ, it begins to punch through the uterine lining. Such a condition creates complications and even infertility, and is known as endometriosis.

Read on to know more about endometriosis and how it can cause infertility.

Endometriosis

When the endometrium tissue spreads to areas like the ovaries, and the abdominal cavity, it can lead to numerous complications. Apart from pain, this may also cause infertility. 5 to 10% of the women worldwide suffer from this condition and have trouble conceiving. Additionally, about 30 to 40% of the infertility cases are due to endometriosis, not all cases. These figures are all confirmed by various medical studies.

How does it cause infertility?

Endometriosis can prevent ovulation, which is the process that occurs every month. During the ovulation process, the ovaries release eggs that may be fertilised in order for the woman to conceive. In this condition, the fimbria of the fallopian tubes also has trouble in capturing the egg, which prevents conception from taking place. This leads to infertility in the long run. Endometriosis also interferes with the proper production of the hormones that are required for normal ovulation and fertilisation of the egg.

Diagnosis: The diagnosis of the condition can be done with the help of lab tests and ultrasounds as well as imaging tests that can create the image of the womb and the endometrium lining. This will help in showing the severity and damage caused by the tissue. A surgical procedure called a laparoscopy may be carried out by the doctor to ascertain whether the patient is suffering from this condition. In this procedure, a small incision will be made and a camera will be inserted to view the insides on a screen, to learn more about the tissue s spread and the kind of treatment that will be required. The doctor will also diagnose the condition on the basis of various symptoms like irregular and heavy bleeding.

Treatment:

Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the age of the woman, the severity of the disease and its location in the pelvis, the length of infertility, and the presence of pain or other symptoms. Some general issues regarding treatment are discussed below.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.

However, several well-controlled studies have shown that neither medical or surgical treatment for mild endometriosis improve the pregnancy rates for infertile women as compared to expectant management (no treatment).

For treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination - IUI is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present.

Details about IUI success rates with endometriosis

IUI and endometriosis

Success rates with IUI for endometriosis have been variable in studies, showing:

A pregnancy rate of 6.5% for women with endometriosis vs. 15.3% per cycle for unexplained infertility
A pregnancy rate of 5.6% for women with advanced endometriosis vs. 22.7% per cycle for mild endometriosis vs. 25.7% for no endometriosis
Pregnancy chances with insemination for natural cycle IUIs (no drugs) with endometriosis are about 2% per cycle vs. 11% with injectables plus IUI for endometriosis
Treatment for severe endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women.

Unfortunately, the infertility in women with severe endometriosis is usually resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, artificial insemination is unlikely to be successful. These women often require in vitro fertilization in order to conceive.

Although the studies of in vitro fertilization for women with severe endometriosis do not all show similar results, pregnancy success rates are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation.

Endometriosis - How It Results in Infertility?

The tissue that lines the uterus is known as the endometrium. In some cases, it can grow outside the uterus. This is known as endometriosis. Endometriosis usually involves organs in the pelvic cavity such as the ovaries, fallopian tubes, bowel and lining of the pelvic cavity. In rare cases, it may involve the vagina, cervix and bladder as well.

Depending on the location and extent of endometrial tissue, it can be classified into four stages ranging from minimal to severe. Most cases of endometriosis fall into the minimal or mild category which involves mild scarring and superficial tissue implants. Moderate or severe endometriosis can cause cysts and severe scarring. Infertility is also commonly associated with severe endometriosis.

Pain in the pelvic area just before and during menstruation is one of the most characteristic symptoms of this disorder. This is because the overgrown endometrial tissue acts like normal endometrial tissue and is shed during menstruation. The only difference is that since there is no exit for this overgrown tissue, it is trapped in the pelvic cavity. The location of the implantation of endometrial tissue also plays a role in the amount of pain experienced. The deeper the implant, more the pain. Implants near areas with high nerve density are also more likely to be painful than implants in areas with low nerve density.  These implants may also release substances into the blood stream that can cause pain.

Other symptoms associated with this disorder are:
  Painful intercourse
  Painful urination
  Pain during bowel movements
  Infertility

These symptoms especially the pelvic pain can vary from month to month in terms of duration and intensity.

A few simple changes in your diet can help manage the symptoms associated with this disorder and in some cases, prevent it as well. Avoid processed food and foods that are high in sodium content. You should also avoid high-fat dairy and food that is rich in arachidonic acid. Instead, increase your consumption of carbs and green leafy vegetables. You could also add two tablespoons of walnut oil a day to your diet to help combat inflammation and the other effects of arachidonic acid.

Early stages of this disease can be treated with hormone therapy, but if it has progressed to the later stages, surgery may be needed. This surgery is performed laparoscopically and aims at removing all the implanted tissue from outside the uterus. However, in cases where the anatomy of the pelvic organs has been distorted by the implants, a hysterectomy may be required. This option, however, it usually considered only in cases where a woman does not have any plans of conceiving more children. 

Endometriosis - How It Is Affecting Your Life?

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