Endometriosis

Endometriosis is a benign pelvic disorder that mostly presents symptoms during reproductive age.

The condition is characterized by the presence of uterine endometrial tissue in other places than the uterine cavity. Endometriosis is often found in the ovaries, on the peritoneum, on the intestines, and near the bladder. The tissue can also implant in the uterine wall (adenomyosis). Wherever the endometrial tissue has implanted, there can be bleeding during menstruation, but there may also be bleeding in the middle of the menstrual cycle. This can lead to the formation of blood-filled cysts (endometriomas) and the development of scar tissue. Scar tissue and adhesions can obstruct the fallopian tubes, leading to infertility.

The exact cause of endometriosis in some women is not fully understood. The spread of endometrial tissue can occur during menstruation when menstrual blood is transported through the fallopian tubes into the abdominal cavity. It is possible for cells from the uterine lining to be carried through blood and lymph vessels to locations outside of the uterus.

There may also be genetic and immunological factors that contribute to a higher prevalence of endometriosis in certain families.

If endometriosis is diagnosed during a laparoscopic examination of the abdominal cavity, and there is a desire to get pregnant, there are two treatment options available (insemination treatment (IUI-H or IUI-D) and in vitro fertilization (IVF / ICSI)). If only mild endometriosis is present and the fallopian tubes are functioning properly, IUI may be performed. If the endometriosis is more extensive, IVF/ICSI treatment is recommended.

In some situations, surgical removal of endometrial tissue is recommended before starting any fertility treatment. Especially if a woman is experiencing debilitating pain or has large blood-filled cysts (endometriomas) in one or both ovaries. However, there is a risk of losing healthy ovarian tissue during surgery, so the indication for the operation must be clear.

Endometriosis is a common disorder. It is estimated that approximately 10% of all women of reproductive age have this condition. Many women have endometriosis without even being aware of it.