Guest post by Ms Rebecca Bugeja
Endometriosis is a disease where tissue such as that found in the uterine lining outside the uterus, particularly in the organs found in the abdomen such as the bowel and bladder. This tissue, like that found in the uterus itself, responds to hormones such as oestrogen.
Therefore, such tissue tends to proliferate and thicken during the menstrual cycle and like what happens during a menstrual period, endometriosis tissue shed from the organ it was adhered to.
The blood and tissue retained in the abdomen and pelvis cause all sorts of complications including inflammation, and adhesions (when the tissue, which is irritating to the body, causes neighbouring organs to stick together). Symptoms for such a condition often vary and must be considered on a case-by-case basis depending on which organ has been affected by it.
For example, if the ovary and the rest of the female genital tract have been affected, the woman may experience abnormal bleeding from the vagina and excruciating abdominal pain. If the bladder has been affected, the woman may experience painful urination and bloody urine associated with the menstrual cycle [].
Multiple factors can contribute to a woman with endometriosis having fertility problems. Endometriosis itself is a chronic inflammatory state. Such irritating tissue not effectively cleared by the immune system causes this inflammatory state.
Also, the abdominal fluid found in women suffering from endometriosis shows higher concentrations of inflammatory chemicals such as prostaglandins and pro-inflammatory chemokines. These increased levels of inflammatory chemical messengers as well the adhesions found in such a condition both contribute to impairment in the transport of the oocyte to the fallopian tube. [, ].
Despite all this, hope is not all lost. Depending on the severity of the endometriosis one has, people may qualify for laparoscopic surgeries where the irritating tissue can be ablated/burnt off or excised/cut off from the organs the tissue adhered to. The downside here is that the woman needs to undergo multiple surgeries of this nature to restore her normal pelvic anatomy. Such surgeries aim to restore the normal pelvic anatomy and therefore, better the chances of the woman carrying a successful pregnancy [, ].
If the woman has severe endometriosis, has tried multiple anatomy-restoring surgeries, and wishes to expand her family, another option would be to use assisted reproductive technology instead of undergoing another anatomy-restoring surgery. Parazzini (1999) found that in women with severe endometriosis, such women having undergone 2 rounds of IVF had a significantly higher pregnancy rate compared to others who have conceived naturally after having received multiple laparoscopic laser surgery (70% vs 15%) [].
Disclaimer: Opinions and thoughts expressed within this article do not necessarily reflect those of the University of Malta. This is just an article that details facts on these conditions and should not be used to self-diagnose. If you are experiencing symptoms, please consult with your doctor.
