Endometriosis
Medical Author: Melissa Conrad Stoppler
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
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Endometriosis and Infertility
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
 Viewer Question: Will endometriosis affect my ability to have children?
Expert's Answer: The mechanism for impaired fertility may involve both anatomic distortion from pelvic adhesions, endometriomas, and the production of substances (for example, prostanoids, cytokines, and growth factors) which are "hostile" to normal ovulation, fertilization, and implantation.
There has been a long-running controversy regarding how endometriosis might be related to infertility.
Endometriosis is more common in infertile compared to fertile women, but the condition usually does not fully prevent conception.
The reasons for a decrease in fertility are not completely understood, but might
be due to both anatomic and hormonal factors. The presence of endometriosis may
involve masses of tissue or scarring (adhesions) within the pelvis that may
distort normal anatomical structures, such as Fallopian tubes, which transport
the eggs from the ovaries...
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What is endometriosis?
Endometriosis is the growth of cells similar to those that form the inside of
the uterus (endometrial
cells), but in a location outside of the uterus. Endometrial cells are the same
cells that are shed each month during menstruation. The cells of endometriosis
attach themselves to tissue outside the uterus and are called endometriosis
implants. These implants are most commonly found on the ovaries, the Fallopian
tubes, outer surfaces of the uterus or intestines, and on the surface lining of
the pelvic cavity. They can also be
found in the vagina, cervix, and bladder, although less commonly than other
locations in the pelvis. Rarely,
endometriosis implants can occur outside the pelvis, on the liver, in old
surgery scars, and even in or around the lung or brain. Endometrial implants,
while they can cause problems, are
benign (not cancerous).
Who is affected by endometriosis?
Endometriosis affects women in their reproductive years. The exact prevalence of endometriosis is not known, since many women may have the condition and have no symptoms. Endometriosis is estimated to affect over one million women (estimates range from 3% to 18% of women) in the United States. It is one of the leading causes of pelvic pain and reasons for
laparoscopic surgery and hysterectomy in this country. While most cases of endometriosis are diagnosed in women aged around 25-35 years, endometriosis has been reported in girls as young as 11 years of age. Endometriosis is rare in postmenopausal women. Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.
Next: What causes endometriosis? »
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