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Endometriosis

The lining of the uterus contains endometrial cells that normally increase during the ovulation cycle so that the endometrium (lining of the uterus) is prepared to accept and support a developing pre-embryo. 

 

Endometriosis occurs when the endometrial cells move through the Fallopian tubes, enter the abdominal cavity, and attach to organs such as the uterus, fallopian tubes, or ovaries.  Endometriosis has been found in most parts of the body including the lungs and brain, so there may be other methods for its growth outside the pelvis.

 

Endometriosis can grow and spread rapidly under the influence of estrogen. Endometriosis can attach to organs, or other structures, and continue to grow and divide often damaging or penetrating the organ. For example, endometriosis can attach to, penetrate, or completely block the fallopian tubes.

 

When the immune system attacks endometrial cells it creates an inflammatory environment in the pelvic cavity which can sometimes interfere with normal fertility.

 

Endometriosis is thought to be caused by the “back flow” of menstrual blood, rich in endometrial cells, into the pelvic cavity during menses.  The immune system destroys the majority of endometriosis but some may still penetrate the body’s defenses. If the immune system is weakened, or does not recognize endometriosis, it can proliferate. 

 

Women whose mother’s had endometriosis are more likely to have endometriosis lending support to a genetic link.

 

Endometriosis symptoms can include pain during menstruation or throughout the menstrual cycle, painful urination or bowel movements, and/or painful intercourse. When endometriosis damages the reproductive organs, it can lead to infertility.

 

Endometrial growth is stimulated during the menstrual cycle. Likewise when endometriosis cells attach to an organ, estrogen continues to stimulate their growth. One treatment for endometriosis is to lower the levels of estrogen by using a drug like Lupron thus “starving” the endometriosis of estrogen.  Laparoscopic surgery is sometimes necessary to completely remove the implants, cut scar tissue and separate pelvic organs.

 

Laparoscopic surgery for infertility should ideally be performed by a reproductive endocrinology and infertility specialist. Infertility specialists undergo advanced training in laparoscopic surgery and have extensive experience operating on delicate reproductive organs.  They understand if the organs are likely to work normally after performing surgery, and can identify situations necessitating in vitro fertilization.