What is Endometriosis?

Endometriosis is a disorder in which tissue that usually lines the uterus, called the endometrium, grows outside the uterine cavity.

 

 It can adhere to the outside of the uterus, the ovaries, and the fallopian tubes. The ovaries release an egg each month, and the fallopian tubes carry the egg from the ovaries to the uterus.

 

 When any of these organs are damaged, blocked, or irritated by endometrium, getting and staying pregnant can become more challenging. Your age, health, and the severity of your condition will also affect your chances of carrying a baby to term. 

 

One study found that 15–20% of fertile couples attempting to become pregnant will be successful each month. That number drops to 2­–10% for couples affected by endometriosis.

 

Common symptoms of endometriosis

The most common symptom of endometriosis is pain, including pelvic pain and cramping solid, painful sex, and pain during urinating or defecating, especially during your period. 

 

 Infertility can, unfortunately, also be a symptom and side effect of endometriosis. An estimated one-third to one-half of women with endometriosis report difficulty getting pregnant.

 

If you’ve had difficulty getting pregnant due to endometriosis, you may wish to visit a fertility clinic. Specialists can determine the severity of your endometriosis and what could contribute to your infertility.

 

In Nigeria, it's looked away as period pain. If you experience severe period cramps consecutively, please visit a health facility for a proper diagnosis. 

 

Type of endometriosis

Generally, there are four types, but endometriosis can be grouped by the area of the pelvis or abdomen affected. 

 

• Superficial peritonial endometriosis 
•  

This is the least severe type of endometriosis. A film covers most parts of the pelvic cavity, and the peritoneal attaches to the endometrium.

 

• Endometriomas

These are dark-coloured cysts common in the ovaries. They also are located in different parts of the pelvis or abdomen. Though not as common as the ovaries. 

 

• Deeply infiltrating endometriosis
•  

This uncommon type appears in only 1 to 5% of people. In this condition, the endometrial tissue invades organs in and outside the pelvis, such as the rectum, bladder, ovaries, and bowels. This is also known as a frozen pelvis.

 

• Abdominal wall endometriosis
•  

Here, the endometrial tissue attaches to the abdominal wall.

 

What causes endometriosis?

There isn’t an exact known cause yet. Genes may poplar a role here. In this case, it gets worse as each generation progresses.

 

If your mother or sister has endometriosis, you'll likely get it. However, tissue scar from incisions like C-section endometrial cells may attach to the incision. 

 

Can endometriosis cause infertility?

Endometriosis is one of the leading causes of infertility in Nigerian women after fibroid. When it affects the reproductive system; 

• It prevents the passage of sperm to the fallopian tube
• It may wrap the ovaries and prevent egg release

 

What are treatments for endometriosis-related infertility?

Freezing your eggs

Endometriosis can affect your ovarian reserve, so some doctors may recommend preserving your eggs now if you wish to become pregnant later. This option can be costly, especially in private facilities in Nigeria. 

 

Superovulation and intrauterine insemination (SO-IUI)

 

This is an option for women who have regular fallopian tubes, mild endometriosis, and whose partner has a good-quality sperm. A doctor will prescribe fertility medications that will help produce two to three mature eggs.

 

A woman will regularly undergo ultrasounds to ensure the eggs are most mature. When the eggs are ready, a doctor will insert a partner’s collected sperm into their uterus. 

 

In vitro fertilization (IVF)

This treatment involves extracting an egg from you and sperm from your partner. The egg is then fertilized outside the body and implanted into the uterus. The success rates of IVF are 50% for women who don’t have endometriosis. 

 

But many women with endometriosis have successfully gotten pregnant thanks to IVF treatments. IVF is often recommended for women with moderate to severe endometriosis or those whose bodies haven’t responded to other treatments.

 

There is no evidence that taking medicines can improve a woman’s chances of getting pregnant with endometriosis. But doctors may prescribe medications, such as progestins, to increase the number of pregnancy hormones in a woman’s body. 

 

It’s also essential to live as healthy a lifestyle as possible when you have endometriosis and are trying to get pregnant. This can reduce inflammation in your body and prepare it to help your baby grow and thrive throughout a healthy pregnancy.

 

Sometimes your doctor might opt for surgery. They will remove the endometrial tissue and create a path for the passage of sperm. 

 

What happens when I see a doctor for the first time?

Your doctor will diagnose you if you have endometriosis. They may carry out the following test:

 

• Pelvic exam

Your doctor may be able to feel the lesion or cyst behind your uterus. This is an invasive procedure.

 

• Imaging test

A CT scan or ultrasound can reveal detailed images of your organs.

 

• Laparoscopy

Your doctor will make a small cut on your belly and insert a thin tube with an attached camera. They’ll be able to see how large the cysts are. 

 

• Biopsy

Your doctor takes out a small tissue, and a lab specialist runs it through a microscope to ascertain if you have endometriosis. 

 

Getting pregnant and having a healthy baby are possible and common with endometriosis. Endometriosis may make it more difficult for you to conceive than women without this condition. It may also increase your risk for serious pregnancy complications. Adopt a healthy lifestyle, eat right, exercise more, and avoid stress. 

 

Pregnant women with the condition are considered high risk. You should expect to have more frequent and careful monitoring throughout your pregnancies so that your doctor can quickly identify any complications if they do arise.