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How Endometriosis Affects Fertility: What to Know Before Trying to Conceive

Endometriosis is a common yet often misunderstood condition that can significantly impact fertility. If you have been diagnosed with endometriosis and are trying to conceive, understanding how the condition affects egg quality, ovulation, and implantation is essential. Here’s what you need to know about endometriosis and fertility.

How Endometriosis Impacts Fertility

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often on the ovaries, fallopian tubes, and surrounding pelvic structures. This can lead to inflammation, scar tissue, and adhesions, which may affect fertility in several ways:

• Egg Quality: Chronic inflammation caused by endometriosis can harm egg quality, making fertilization more difficult.

• Ovulation Issues: Endometriosis can interfere with normal ovulation by disrupting hormonal balance or causing cysts (endometriomas) on the ovaries.

• Implantation Problems: Even if fertilization occurs, the inflammation and scarring from endometriosis can make it more difficult for a fertilized egg to implant in the uterine lining.

• Fallopian Tube Blockage: Adhesions and scar tissue may block or distort the fallopian tubes, preventing sperm from reaching the egg or stopping a fertilized egg from moving into the uterus.

When to See a Reproductive Endocrinologist

If you are struggling to get pregnant and suspect endometriosis may be a factor, consulting a reproductive endocrinologist can help determine your next steps. Consider seeking expert care if:

• You have been trying to conceive for six months or longer (if over 35) or one year (if under 35) without success.

• You experience severe pelvic pain during menstruation, intercourse, or ovulation

• You have irregular menstrual cycles

• You have a history of ovarian cysts 

A reproductive endocrinologist can evaluate your fertility status through imaging, blood tests, and minimally invasive procedures like laparoscopy. They can also recommend fertility treatments tailored to your condition, such as in vitro fertilization (IVF).

Mild vs. Severe Endometriosis

Endometriosis is classified into four stages based on the location, extent, and amount of endometrial-like tissue affecting surrounding reproductive structures. 

• Mild (Stages I & II): In the early stages, small patches of endometrial-like tissue typically grow on the peritoneum (the membrane that lines the abdomen). In Stage II, endometriosis may begin affecting the ovaries. Scar tissue is typically not present in the early stages, and patients may still be able to conceive naturally.

• Moderate to Severe (Stages III & IV):  In Stages III and IV, endometrial tissue implants become larger and deeper, penetrating multiple organs, including but not limited to the ovaries, rectum, and bowels. In these cases, surgery may be recommended to remove scar tissue or large endometriotic cysts. If pregnancy does not occur within 6 months after surgical treatment of endometriosis,  assisted reproductive technologies like IVF may present the best option for conception.  

Next Steps

At Orlando IVF, our team of reproductive specialists understands the complexities of endometriosis and fertility. We offer advanced diagnostic tools and personalized fertility treatments to help you achieve your dream of parenthood. Contact us today to schedule a consultation and take the next step toward building your family.

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