Pelvic adhesions, or scar tissue formation in the pelvis, can lead to infertility. Many triggers can lead to adhesion formation, including endometriosis, previous surgery, pelvic infections, gonorrhea, chlamydia, and pelvic inflammatory disease (PID). When a woman ovulates, the oocyte, or egg, is released from the ovary. The egg is then picked up by the fallopian tube. If there are adhesions in the pelvis, they can interfere with the transport of the egg into the fallopian tube. This transport interference can lead to infertility issues. It can also lead to an ectopic pregnancy if the egg is fertilized but then becomes trapped in the pelvis. An ectopic pregnancy is when a fertilized egg (embryo) implants and grows outside of the uterus.
Endometriosis Treatment Center
Endometriosis is one of the leading causes of pelvic adhesions and pelvic pain. The endometrial layer of the uterus is the layer that lines the inside of the uterus (womb). It is the layer that grows every month during the menstrual cycle and then bleeds off during a period. This tissue can become displaced and implant into the pelvis or nearby organs such as the bladder, bowel, ovaries, or fallopian tubes. The displaced endometrial tissue then grows during the menstrual cycle and can bleed during the period, which can cause significant pelvic inflammation, pain, and adhesions.
What causes endometriosis?
There are many theories as to the cause of endometriosis, but the exact cause of endometriosis is unknown. In most patients, the most likely cause is retrograde menstruation. Retrograde menstruation is when some of the fluid from a women’s menstrual bleed goes up (retrograde) through the fallopian tubes rather than exiting out of the body through the vagina. This fluid travels through the fallopian tubes and even into the pelvis. The fluid contains endometrial cells which can implant and grow in the pelvis, resulting in endometriosis.
How do you diagnose endometriosis?
Sometimes endometriosis is diagnosable using imaging studies such as ultrasound or MRI. Officially, endometriosis is only diagnosable by biopsying (removing) some of the tissue that may contain endometriosis. We examine the tissue under a microscope, and if endometrial tissue is present, we diagnosis the patient with endometriosis. While this method is the only official method for diagnosing endometriosis, it is very invasive.
How does endometriosis affect fertility?
Endometriosis can affect fertility in several ways. The most obvious way is that endometriosis can lead to scar tissue or adhesions in the pelvis. If the adhesions inhibit the transport of the egg, infertility will result. Endometriosis also causes inflammation in the pelvis. This inflammatory reaction can create an inhospitable environment for the embryo and can inhibit its growth and development. This too will result in infertility.
What can improve fertility in people with endometriosis?
There are many different treatment options for women with endometriosis who are trying to conceive. Over time, the options have changed considerably. One of the older standard options was surgery. More recent studies have indicated that women with severe endometriosis and adhesions can benefit from in vitro fertilization (IVF) instead of surgery. IVF at an endometriosis treatment center essentially bypasses the pelvis and fallopian tubes. Therefore, severe adhesions will have no impact on overall success rates with IVF. In less severe cases of endometriosis, less invasive fertility treatment is possible. This includes options such as oral medications (e.g., Clomid), injectable gonadotropins, and inseminations (IUI).
At Advanced Reproductive Center, we customize the treatment plan based upon each unique patient’s situation. If you need professional fertilization services at our endometriosis treatment center, then call Advanced Reproductive Center today at 312.485.4847!