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Endometriosis and infertility

The impact of endometriosis on a woman’s spontaneous fertility varies. The degree to which fertility is impaired depends on the degree of severity of the disease in the individual case. The abnormality responsible may be located in the region of the ovaries, the fallopian tubes or in the surrounding peritoneum.

Endometriosis causes tissue inflammation and irritation which is reproduced time and again with the rhythm of the menstrual cycle. This inflammation triggers the release of biochemical inflammatory factors which disrupt maturation of the ovum, ovulation and fertilisation of the ovum. Furthermore, adhesions on the mucous membrane of the fallopian tubes and the surface of the ovaries can mean, in the ovary, that the ovum is not properly captured by the fallopian tube after ovulation.

Endometriosis cysts in the ovaries directly impair the maturation of ova, which makes normal ovulation impossible.

The defensive reaction of the immune system against the displaced endometrium, which is seen as a foreign body, can prevent implantation of the embryo in the uterus. A particular form of endometriosis, known as adenomyosis of the uterine musculature, can also disrupt implantation of the fertilised ovum in the uterine cavity.

In severe forms of endometriosis, sexual relations may be very painful and, as a consequence, may be virtually impossible.

Treatment and prospects of success

Infertility can be caused by just a few endometriosis sites which, being totally painless, often go undetected. This is why the possibility of endometriosis must always be considered when a woman wants a baby but is unable to conceive. Early diagnosis and correct treatment of endometriosis may make it possible to overcome infertility.

Supported by AstraZeneca