Endometriosis is the condition in which the endometrium, meaning the tissue that normally covers the inside of the uterus, is mistakenly deposited outside the uterus for unknown reasons and most commonly around the peritoneum, ovaries and sacro-uterine ligaments but can also be deposited much on mush more distant tissues such as the chest or brain. If anyone is wondering how common endometriosis is, they should know that it affects about 20% of women of reproductive age and is found in about 50% of cases of unexplained infertility.
Endometriosis is a very special condition and its clinical impact cannot be easily predicted. As mentioned earlier, endometriosis can present together with infertility in about 50% of cases and coexist also with other symptoms such as dysmenorrhea, period pain, both symptoms or even none of the two. On the other hand, there are a few cases in which, while there is intra-abdominal endometriosis, the patient has never had experienced pain during her period or even managed to conceive easily naturally!
The diagnosis and treatment of endometriosis is carried out only by laparoscopy. From blood draw exams, the only biochemical value that can be found high is the Ca125 index, but since this rises in only 20% of cases it can’t be an exclusive criterion for documenting the endometriosis diagnosis. If mild endometriosis foci are found and cauterized during the laparoscopy, the couple can increase the chances of spontaneous conception by 60-70%, provided of course that all the necessary conditions are met to achieve this. In more severe forms of endometriosis, the clinician suggests applying period suppression medication for one to three months in order to prevent its recurrence. In the cases of women in a hurry to start the reproductive attempts, it is preferable to avoid medication and immediately start free contacts.
To sum up, it must be emphasized that endometriosis is present in many patients with unexplained infertility. Early diagnosis and treatment can prevent unnecessary cycles of assisted reproduction and reassure the higher chances of natural conception to the couple.
