What is endometriosis? Endometriosis and IVF

Endometriosis is a condition where cells that normally line the uterus begin to grow on the outer surface of the uterus and can invade the ovary, causing blood-filled cysts called endometriomas. Endometriomas can be difficult to diagnose, and even misdiagnosed, because size, shape, and placement can vary from patient to patient. These "chocolate cysts," so named due to the appearance of the darkened blood that collects within the cysts, can range from a few millimeters to upwards of 8 centimeters. These endometriomas can cause scar tissue formation in surrounding tissues, which can lead to pain and discomfort.

Every month, when you are due for your period, hormonal factors cause your endometrial lining to shed and result in a period. However, if you have endometrosis, the lining has nowhere to be shed and instead these endometrial cysts form, which can interfere with normal ovulation. Because of this, 30-40% of women with endometriomas are infertile or will have trouble conceiving.

Some women with the disease will show symptoms, which can help lead to a diagnosis. However, some patients are asymptomatic. Women who are asymptomatic may not be diagnosed until they go into surgery for cysts or until they discover problems with infertility.

Symptoms of endometriosis include:

• Severe menstrual cramping
• Excessive menstrual bleeding
• Chronic pelvic and/or lower back pain or pain with intercourse
• Painful ovulation
• Pain while having a bowel movement
• Infertility

Treatment options are available and vary from patient to patient, depending on their main outcome for treatment

Some want to reduce pain and improve quality of life, while others are more concerned with being able to conceive. Medical treatment utilizing hormone therapy can be used to reduce symptoms and try and prevent endometriomas from forming. Another option is surgical treatment, normally achieved by laparotomy or laparoscopy. Surgical treatment aims to alleviate symptoms, reduce and/or remove endometrial implants, restore normal anatomy, and stop the disease from progressing.

For patients who have the end goal of conceiving, in-vitro fertilization (IVF) treatments are more successful

than other forms of hormone therapy or laparoscopic surgeries when it comes to improving fertility rates, especially in cases of advance stages of endometriosis or diminished ovarian reserve. If you have endometriomas and have a low AMH and low ovarian reserve, IVF will be your best chance to conceive. These are crucial considerations if you have endometriosis and IVF versus laparoscopy or other next steps are under consideration.

To see a Board Certified fertility specialist with expertise in endometriosis and IVF and other fertility treatments, schedule an appointment at one of InVia's four Chicagoland locations.