How Does Endometriosis Affect Fertility?

Endometriosis has a dramatic impact on fertility. Statistics show that 30%-50% of women with endometriosis have difficulty getting pregnant and that endometriosis is responsible for infertility in 5%-15% of all couples.

Your risk for infertility is something we take seriously at Alpenglow Gynecology. We’re also concerned that many women with endometriosis remain undiagnosed, so they’re not aware they could be on the road to developing a fertility problem.

Here’s what you need to know about endometriosis and infertility. If you have any questions about potential symptoms, call our office.

Endometriosis basics

Endometriosis develops when the tissue that normally lines your uterus, called the endometrium, grows on structures outside the uterus. While there are several theories about how that can happen, most experts believe it occurs due to retrograde menstruation.

So, what’s retrograde menstruation? That’s when some of your period flows backward, going out through your fallopian tubes and into your abdominal area. Your periods carry pieces of endometrial tissue, and once they’re outside the uterus, they attach to nearby organs and continue to grow.

These patches of endometriosis function just like they were still inside your uterus. They respond to hormones and bleed every month when you menstruate. Problems arise because the bleeding stays in your abdomen, where it causes inflammation and scarring. 

Signs you have endometriosis 

Endometriosis doesn’t always cause symptoms. But if you have symptoms, you experience pain — pelvic pain, painful menstrual periods, and pain during the week before your periods.

You may also have other types of pain depending on where the patches of endometriosis are located. For example, when endometriosis grows on the urinary bladder, it makes urination painful.

Your symptoms — whether they’re present or absent, minor or major — aren’t related to the severity of your endometriosis. You may have no symptoms with extensive endometriosis, or brutal symptoms from a few small patches of endometriosis. However, the extent of your endometriosis does impact your fertility.

How endometriosis affects fertility 

Endometriosis most often develops on your fallopian tubes, ovaries, and the outer wall of your uterus. As a result, these reproductive organs become damaged due to inflammation, scarring, and adhesions. Chronic inflammation alone creates a toxic environment that affects every aspect of your fertility, from the quality of your eggs and sperm motility to the health of your uterus.

Scar tissue and adhesions pose another problem. Adhesions occur when scarring makes two or more organs or tissues stick together. Even worse, adhesions can twist or pull your reproductive organs or make them stick to your abdominal wall.

As adhesions caused by endometriosis distort your reproductive organs, they may block ovulation or prevent an egg from attaching to the uterine lining. Distortion may obstruct the fallopian tubes, which prevents the egg and sperm from uniting. The more distortion that occurs, the higher your risk for infertility.

Even if your endometriosis is mild, you can still face fertility problems, due to: 

Toxic substances

The endometrial patches secrete substances that may be toxic to eggs or sperm. 

Hormone imbalance

Patches of endometriosis may produce estrogen, leading to hormone imbalances that affect egg development, prevent ovulation, or stop a fertilized egg from attaching to your uterus. 

Immune dysfunction

The experts know that women with endometriosis have higher levels of certain types of immune cells, but they’re not sure exactly how that affects fertility. Some of the immune cells may contribute to implantation failure.

At the first sign of menstrual or pelvic pain, call Alpenglow Gynecology or schedule an appointment online so you can learn if you’re at risk for endometriosis or infertility.

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