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“Endometriosis and Infertility: Can Surgery Help?” Patient Fact Sheet by ASRM

“Endometriosis and Infertility: Can Surgery Help?” Patient Fact Sheet by ASRM

This fact sheet was developed in collaboration with The Society of Reproductive Surgeons

When you have your period, your body is actually getting rid of the tissue called endometrium that lines your uterus (womb). Normally, this tissue grows only on the inside of the uterus. But it may grow in other places: on the outside of your uterus, ovaries or tubes. It can even grow on your bladder or intestines. If it does, the condition is called endometriosis. The tissue growth can irritate the organs and other structures that it touches, causing you pain. The irritation can cause adhesions or scar tissue on these organs.

Many women with endometriosis have pain in the lower abdomen or pelvis, particularly with their menstrual bleeding. Other women have endometriosis without significant pain. Often, the endometriosis tissue -- and the scarring that may occur -- can make it difficult or impossible to get pregnant. In fact, 30% to 50% of infertile women (women who cannot get pregnant) have endometriosis.

How can I tell if I have endometriosis?

Your doctor will want to know your symptoms, but the only way to tell for certain if you have endometriosis is through a "minimally invasive" surgical procedure called laparoscopy. In this surgery, the surgeon will look for endometriosis tissue with or without adhesions (scar tissue). Sometimes, endometriosis can grow inside your ovary and form a cyst. These cysts are very common in women who have endometriosis. They usually can be seen on ultra- sound, unlike other endometriosis tissue. These cysts or endometriomas may need to be surgically removed, most commonly with the laparoscope.

How is laparoscopy performed?

Laparoscopy is called a "minimally invasive" surgery because the surgeon makes very small openings (incisions) at (or around) your belly button and lower portion of your belly. A thin telescope-like instrument (the laparoscope) is placed into one incision, which allows the doctor to look for endometriosis using a small camera attached to the laparoscope. Small instruments are inserted through the incisions to remove the tissue and adhesions. Because the incisions are very small, you will only have small scars on your skin after the procedure. You usually can go home the day you have your surgery and should be able to return to your usual activities.

As is the case for any surgery, there is a small risk of complications. These risks include bleeding, infection, your reaction to anesthesia, and damage to your bowel or other organs. However, these risks are unlikely.

Will I be able to get pregnant after the surgery?

Depending on the extent of endometriosis, surgery may improve your chances of getting pregnant, but doctors will not know exactly how much better your chances will be. If you do not get pregnant within a reasonable time frame after the surgery, it probably won't help to have surgery again unless there is a new problem. Because a second surgery may not improve the chances of success substantially, you have to take into consideration the potential complications as well as the expense of having a second surgery compared with the expense of infertility treatment. Infertility treatment can often overcome the effects of endometriosis without surgery, but it cannot make an endometrioma go away.

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE
1209 MontgomeryHighway
Birmingham, Alabama 35216-2809
T E L (205) 978-5000
FAX (205) 978-5005
E-MAIL: asrm@asrm.org
Web: www.asrm.org

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  • Endometriosis

    What is Endometriosis?

    Endometriosis is a common and chronic gynecological disease that can result in cyclic pelvic pain that occurs in conjunction with a woman's periods. About 10% of women of reproductive age and up to 50% of women with infertility have endometriosis. That amounts to approximately 5.5 million women in the United States and Canada.

  • Cancer and Fertility Preservation: Patient’s Fact Sheet by ASRM

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  • Painful Periods

    Causes

    The pain of periods is caused by contractions of the uterus or womb, similar to those of another 'normal' pain women suffer - during labour.

    Mild contractions constantly pass through the muscular wall of the womb, although most women are unaware of them. During menstruation, however, they are stronger than normal and during labour they're stronger still.

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    With Acute Pelvic Inflammatory Disease (PID):

    • severe pain and tenderness in the lower abdomen with vaginal discharge, often accompanied by fever.

    With Chronic PID:

    • mild, recurrent pain in the lower abdomen, sometimes accompanied by backache or irregular menstrual periods.
    • pain during intercourse.
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    • heavy, unpleasant-smelling vaginal discharge

    Call Your Doctor If :

  • Acute Pelvic Inflammatory Disease

    Symtopms

    With Acute Pelvic Inflammatory Disease (PID):

    • severe pain and tenderness in the lower abdomen with vaginal discharge, often accompanied by fever.

    With chronic PID:

    • mild, recurrent pain in the lower abdomen, sometimes accompanied by backache or irregular menstrual periods.
    • pain during intercourse.
    • infertility.
    • irregular menstrual periods.
    • heavy, unpleasant-smelling vaginal discharge

    Call Your Doctor If :

  • Qus & Ans: Unexplained Infertility

    I have been trying to conceive for two years now and recently I read an article about dysmenorrhea. I feel that I have some signs of this, like painful periods that bring me to tears. I also read that it can cause infertility. How true is this? Should I discuss this with my doctor before getting fertility tests done?

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