March is recognised as Endometriosis Awareness Month, and we have been bringing you stories about the condition, as well as contributions from the brave women who are fighting the battle. This week we address the issue of endometriosis and fertility, through a reprint of a piece from Dr Ryan Halsall, obstetrician- gynaecologist at Island Laparoscopy. Visit his website at www.ilapmedical.com or follow him on Instagram @drhalsall.
SO what is the link between infertility and endometriosis? Well, to understand the link, you must first understand how a woman gets pregnant. There are four main factors that affect a couple getting pregnant:
1. Eggs — The woman must be producing eggs regularly to be fertilised.
2. Fallopian tubes — The tubes must be open and working properly to allow the fertilised egg to get into the womb.
3. The womb — Must be able to accept the fertilised egg.
4. Sperm — The man needs healthy sperm to fertilise the egg.
Almost all of those steps can be affected by endometriosis in some way or form.
Egg production & release
Endometriosis can completely take over an ovary through the development of blood-filled cysts (chocolate cysts), destroying normal ovarian tissue. At times this requires surgery which may involve removal of the entire ovary. Even with the ovaries intact, the long-standing inflammation in the ovary can prevent/impair egg release.
Endometriosis can completely block the tubes and prevent transportation of the egg. Even if it doesn't block it completely, the inflammation can cause scarring that will distort the tubes and impair egg transport. In some cases, the egg may get fertilised but not get transported into the womb because of this tubal damage, leading to what is known as an ectopic pregnancy which can be life threatening.
It is believed that the long-standing inflammation associated with endometriosis can be toxic to sperm itself!
It's very important to note that in up to 30 per cent of infertile couples, both parties have an issue. This is why it's most important for the couple to both go to the consultation. It makes no sense for the woman to go through batches of tests and possible surgeries to fix her issue, and all the while the man has a problem with his sperm. Even if he's had a child before, it doesn't matter — times and things change.
Treatment, of course, will depend on what the underlying issue is, and ranges from medication and surgery to assisted reproductive techniques like in-vitro fertilisation (test tube babies). Most women with endometriosis eventually get pregnant, so speak to your gynaecologist to discuss your individual options today.