Dr.Anita Mani
***Infertility& Surrogacy Specialist at Gift IVF Centre
EARLY DIAGNOSIS OF ENDOMETRIOSIS FOR INFERTILITY
Infertility problems in women can be congenital (from birth) or can be caused by various factors.Endometriosis is one of the medical conditions, which leads to infertility in women.
Endometriosis Is a condition, when inner uterine lining ( endometrial lining) grows outside the uterus, often affecting the function of the ovaries, uterus and fallopian tubes.This tissue will bleed every month , internally , during the menstruation time, and the blood collects inside, which acts like a gum sticking together, the internal organs like intestines / urinary bladder to uterus, tubes and ovaries .Sometimes, the collection is big enough to form a chocolate cyst, which is nothing but old blood.We have removed a 30 cm cyst in a patient.It was bigger than a large watermelon.Even a small spot measuring 5 cm can cause infertility in some women and often goes undiagnosed.
This extra tissue growth can cause scarring or obstruction of the tube producing tubal blocks.This can also produce certain chemicals, impairing the implantation of the fertilised egg inside the uterus.Symptoms are painful menstruation or painful intercourse, acute or chronic pain in pelvic area and infertility.In some women the pain is very acute and it interferes with the day to day activities of her life.some times there will be no visible symptoms.
The word endometriosis comes from the word “endometrium”, endo means “inside” and metrium means “mother”.There may be no specific reason for getting endometriosis, it can affect any women, but family history suggests genetic linkage .Theory of back bleeding also seems logical, as we often find blood around the uterus in pelvis , while we do laparoscopy for women during their period time.Also the cervix is quite tightly closed in some women, which may be causing back bleeding, and the endometrium which is shed along with the menstrual blood is pushed up thru the tubes to the pelvis, where it gets collected and grows responding to the hormones in the subsequent cycle.The contraction of uterus is abnormal in some women which can also attribute to back bleeding, they may even end up in ectopic pregnancies .
Endometriosis can stand in the way of pregnancy, infact a very large percentage of infertile women suffer from this condition.Though most of the times you can detect this through clinical examination, ultrasound or MRI scan, confirmation is possible only through laparoscopy.Laparoscopy is the gold standard in the treatment of endometriosis and should be done early in this condition, if it is too late we cannot save the tubes, if it is severely damaged.
Solution is to surgically remove endometrial tissues, cauterise it to destroy it ( electro- cautery is used to burn the spots ) or unblock tubes.Medical therapy can be used to stop them ovulate, which in turn, will stop the growth of lining .The side effects of medical treatment can be hard, as they become menopausal, so it is better to opt for surgery .After this up to 40 percent of women get pregnant naturally, rest has to take help of assisted reproductive treatment like IVF or surrogacy.While doing laparoscopy the doctor will evaluate the damage done and inform you if you have further chance for conceiving.Endometriosis cannot be cured, and even after hysterectomy or removal of ovaries, any time it can grow back.
Photo: Dr.Anita Mani
***Infertility& Surrogacy Specialist at Gift IVF Centre
EARLY DIAGNOSIS OF ENDOMETRIOSIS FOR INFERTILITY
Infertility problems in women can be congenital (from birth) or can be caused by various factors.Endometriosis is one of the medical conditions, which leads to infertility in women.
Endometriosis Is a condition, when inner uterine lining ( endometrial lining) grows outside the uterus, often affecting the function of the ovaries, uterus and fallopian tubes.This tissue will bleed every month , internally , during the menstruation time, and the blood collects inside, which acts like a gum sticking together, the internal organs like intestines / urinary bladder to uterus, tubes and ovaries .Sometimes, the collection is big enough to form a chocolate cyst, which is nothing but old blood.We have removed a 30 cm cyst in a patient.It was bigger than a large watermelon.Even a small spot measuring 5 cm can cause infertility in some women and often goes undiagnosed.
This extra tissue growth can cause scarring or obstruction of the tube producing tubal blocks.This can also produce certain chemicals, impairing the implantation of the fertilised egg inside the uterus.Symptoms are painful menstruation or painful intercourse, acute or chronic pain in pelvic area and infertility.In some women the pain is very acute and it interferes with the day to day activities of her life.some times there will be no visible symptoms.
The word endometriosis comes from the word “endometrium”, endo means “inside” and metrium means “mother”.There may be no specific reason for getting endometriosis, it can affect any women, but family history suggests genetic linkage .Theory of back bleeding also seems logical, as we often find blood around the uterus in pelvis , while we do laparoscopy for women during their period time.Also the cervix is quite tightly closed in some women, which may be causing back bleeding, and the endometrium which is shed along with the menstrual blood is pushed up thru the tubes to the pelvis, where it gets collected and grows responding to the hormones in the subsequent cycle.The contraction of uterus is abnormal in some women which can also attribute to back bleeding, they may even end up in ectopic pregnancies .
Endometriosis can stand in the way of pregnancy, infact a very large percentage of infertile women suffer from this condition.Though most of the times you can detect this through clinical examination, ultrasound or MRI scan, confirmation is possible only through laparoscopy.Laparoscopy is the gold standard in the treatment of endometriosis and should be done early in this condition, if it is too late we cannot save the tubes, if it is severely damaged.
Solution is to surgically remove endometrial tissues, cauterise it to destroy it ( electro- cautery is used to burn the spots ) or unblock tubes.Medical therapy can be used to stop them ovulate, which in turn, will stop the growth of lining .The side effects of medical treatment can be hard, as they become menopausal, so it is better to opt for surgery .After this up to 40 percent of women get pregnant naturally, rest has to take help of assisted reproductive treatment like IVF or surrogacy.While doing laparoscopy the doctor will evaluate the damage done and inform you if you have further chance for conceiving.Endometriosis cannot be cured, and even after hysterectomy or removal of ovaries, any time it can grow back.
