Endometriosis and fertility
Endometriosis occurs in 21%to 48% in the infertile women, whereas it is seen in only 1.3–5% of fertile women. The two most common complaints leading to a diagnosis of endometriosis are pelvic pain and infertility. Endometriosis is a disease of younger women. Infertility due to endometriosis could be due to several abnormalities like tubal dysfunction, impaired ovarian reserve, worsening egg quality, defect in implantation and decreased sperm motility inside the female reproductive system. Infertility due to endometriosis at the earlier stages can be treated by simpler treatment like ovulation induction and IUI. However, at advanced stages it requires IVF/ICSI as the disease spreads rapidly and destroys the ovaries. At later stages, usually the women are completely depleted of their eggs and have to go through egg donation programme. Precautions for women with endometriosis If you are experiencing severe pain during cycles it may be due to endometriosis, you must consult local gynaecologist. Diagnosis of endometriosis is usually done with pelvic ultrasound which may show chocolate cysts in the ovaries. It is always better to undergo a laparoscopy to check patency of tubes at this stage if you are trying to conceive. If you are diagnosed as mild to moderate case of endometriosis you should regularly follow up with AMH levels as it can indicate extent of destruction of ovaries. Severe endometriosis needs immediate attention for fertility preservation, you may need IVF at this stage for optimum results.