In some women, the tissue that normally lines the inside of the uterus, called the endometrium, is also found outside the uterus. This tissue usually attaches to the ovaries, bowels, and other tissues in the pelvis, although in rare cases it can spread to other regions of the body. This tissue acts as it normally would if it were in the uterus – thickening, then shedding, as part of the menstrual cycle – but unlike a normal endometrium during a woman’s period, it has no way to leave the body. The immune system treats the bleeding as if it’s a wound, leading to scar tissue, pain, inflammation, bowel issues, and, in some cases, infertility.
Although we know that endometriosis leads to infertility in some women, the specific causes vary from woman to woman: hormones, inflammation, scarring, changes in anatomy, and other factors can all play a part. In general, the best treatments for endometriosis are pregnancy and contraceptive medication, because they both interrupt the menstrual cycle and, therefore, the cycle of endometriosis. Unfortunately, neither of those options are helpful for a women struggling with infertility.
Fertility medications, surgery, intrauterine insemination, and in vitro fertilization are some of the available options for women with endometriosis who struggle with infertility. Shoemaker Ob-Gyn treats each woman individually, taking care to determine the specific cause of her infertility in order to recommend the best treatment option for her body.