How Does Endometriosis Impact Fertility?

Endometriosis is so common studies have shown that as many as 11% of women in Australia are affected by it. The effects of this condition are far-reaching, from pain and psychological trauma to infertility, to mention a few. For many women, reduced fertility or infertility is the biggest concern regarding endometriosis. But how exactly does endometriosis affect fertility? For starters, not every woman with endometriosis has reduced fertility, and not every woman with reduced fertility has endometriosis. Either way, it’s essential to address your symptoms to prevent them from progressing.

Which Organs Are Affected by Endometriosis?

The organs in the pelvic region are most commonly affected by endometriosis, although the
effects may spread further in rare cases. Endometriosis is caused by endometrial-like tissue (tissue similar to that which lines the uterus) that grows outside the uterus.

This may result in bleeding, scarring, and organs within the pelvic area adhering to one another. Endometriosis often results in painful periods, heavy periods, pain during intercourse, reduced fertility, Receptivity of the endometrium and pain within the pelvic area. The ovaries, fallopian tubes, and the tissue lining the pelvis are most commonly affected.

How Endometriosis Affects Fertility

Between 30% and 50% of women with endometriosis may struggle to become pregnant. Fertility is largely dependent on the amount, location, and depth of the endometriosis.

How endometriosis affects your reproductive organs:

  • Adhesions may form in the pelvic area
  • The anatomy of the pelvis may become distorted
  • Scarring may develop in the fallopian tubes
  • Pelvic inflammation may occur
  • The quality of the eggs is affected
  • Immune function is affected
  • Hormonal changes occur
  • The ability of fertilised eggs to implant is affected
  • Cysts called endometriomas may form

Other Causes of Infertility and Reduced Fertility

Endometriosis isn’t the only cause of reduced fertility or infertility. There are many other conditions which may be the culprit. Your doctor may refer to various other conditions such as polycystic ovary syndrome or PCOS, primary ovary insufficiency (POI), uterine fibroids, autoimmune disorders, structural problems in the reproductive system, tubal factor infertility and more.

How Endometriosis is Diagnosed

Endometriosis is famously challenging to diagnose due to the complexity of the condition and the vast array of symptoms. A good doctor will take care to find a diagnosis using the least invasive methods first. They typically start by conducting a thorough pelvic examination, an ultrasound or an MRI. In our hands, expert transvaginal ultrasound is key to the non-invasive diagnosis of endometriosis and planning management. In the event imaging technologies are negative, then laparoscopy, a surgical procedure performed under general anaesthetic, can be considered.

How to Treat Endometriosis-Related Infertility

Endometriosis doesn’t always affect fertility, and when it does, it doesn’t usually wholly prevent pregnancy. In cases where fertility is reduced and women want to seek treatment to improve their chances of getting pregnant, doctors will use a combination of treatment methods. Surgery, assisted reproductive technology, and ovulation induction with intrauterine insemination are common treatments.

It’s important to know that women affected by endometriosis can get treatment to ease their symptoms and improve their fertility. We suggest seeing a team, like Sydney Endometriosis, who work closely with the fertility team at Monash IVF.

OMNI Ultrasound & Gynaecological Care

Condous performs Advanced Endosurgery procedures for women needing intervention for pelvic masses, adnexal pathology, severe endometriosis or hysterectomy. He also runs ‘Hands on’ Live Sheep Laparoscopic Workshops for gynaecologists at Camden Veterinarian School.
Having completed an undergraduate degree with the University of Adelaide, he left Australia in 1993 and moved to London where he completed his training in Obstetrics and Gynaecology. From 2001 to 2003 Condous worked as a Senior Research Fellow at St George’s Hospital, London. At St George’s he set up the Acute Gynaecology Unit, the first in the United Kingdom. It was also during this time that he developed an interest in Early Pregnancy and especially the management of pregnancies of unknown location (PULs). Condous has developed many mathematical models for the prediction of outcome of PULs which have been featured in numerous peer review journals. In 2005, he returned to Australia where he completed his Laparoscopic Fellowship at the Centre for Advanced Reproductive Endosurgery, Royal North Shore, Sydney.

Condous was appointed as a Consultant Gynaecologist and Senior Lecturer at Nepean Hospital in 2006 and soon was made Associate Professor. In 2010, he was made Departmental Head of Obstetrics and Gynaecology at Nepean Hospital. He obtained the MRCOG in 1999 and was made FRANZCOG in 2005. In 2009, he was awarded his Doctorate in Medicine (MD), University of London, for his thesis entitled: “The management of pregnancies of unknown location and the development of new mathematical models to predict outcome”.

Condous has edited three books including the “Handbook of Early Pregnancy Care”, published over 100 papers in international journals and is internationally renowned for his work in Early Pregnancy. He is the Associate Editor for Gynaecologic Obstetric Investigation, which is a European based journal, as well as the Australasian Journal of Ultrasound in Medicine (AJUM). He is on the organising committee and is an invited speaker at the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG) Scientific meeting in Sydney 2013. His current research interests relate to the management of ectopic pregnancy, 1st trimester growth, PULs and miscarriage and the use of transvaginal ultrasound (in particular sonovaginography, to predict posterior compartment deep infiltrating rectovaginal endometriosis).Condous is also actively involved with post-graduate education including the annual running of the Early Pregnancy and Gynaecological Ultrasound Interactive Courses for Sonologists, Radiologists, Sonographers and Gynaecologists in Australia.