Endometriosis – One cause of infertility

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Make sure to read the entire series!

Endometriosis is caused by endometrial tissue built up in areas outside of the uterus, including ovaries, fallopian tubes, uterine ligament, and other organs in the pelvic cavity.

Endometriosis a cause of infertility

Endometrial tissue, whether it is inside or outside the uterus, responds to the rise and fall of estrogen and progesterone produced by the ovaries during the reproductive cycle. Unlike a normal-situated endometrium, which is shed from the body during menstrual discharge, the blood and tissue of a patient with endometriosis have no outlet, therefore the debris and blood accumulate locally. This results in inflammation, adhesions and hemorrhagic cysts (so-called chocolate cysts).

Causes of Endometriosis
The cause of endometriosis is unknown, however there are several hypotheses. One possibility is retrograde menstruation, the backward flow of the menstrual discharge through the fallopian tubes into the pelvis. It is also believed that certain women may develop endometriosis due to deficiencies in their immune systems. Recent research shows that endometriosis may have a genetic component and may run in families.

Symptoms of Endometriosis
Symptoms of endometriosis are usually exhibited during menstruation. The most common symptoms are:

  • Pain and cramping before and during periods (severe progressive dysmenorrhea)
  • Chronic pelvic pain
  • Pain during intercourse
  • Heavy and irregular periods
  • Painful urination or bowel movements during periods
  • Palpable mass
  • Rectal bleeding
  • Infertility

Diagnosis of Endometriosis

  • History taking and physical examination by a gynecologist
  • Ultrasonography
  • MRI
  • Laparoscopy
  • Incidental discovery through other operations
  • Biopsy

Treatment of Endometriosis

  • Laparoscopy – sometimes biopsy can be carried out to confirm diagnosis. For example endometriosis ablation will be performed by electric cauterization. Endometriosis in the ovary may contribute to chocolate cysts which can be removed by laparoscopic surgery
  • Medical Treatment – The Medications that are normally used are in the group of Gonadotropin-Releasing Hormone Agonist (GnRHA), but other hormones can be used
  • Removal of the uterus with/without the ovaries may be indicated in severe cases, or when the couple does not have future plans for having children

Even though endometriosis is not a life threatening disease, without treatment it can get worse over time resulting in chronic illness and poor quality of life.

Samitivej, We Care!

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181
E-mail: info@samitivej.co.th
Facebook: www.facebook.com/samitivej

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Samitivej Womens Health Center

Samitivej Hospitals are world class international health care facilities located in Bangkok, Thailand.

Fully equipped with the state-of-the-art technologies, our innovative Women's Health Center at Samitivej Sukhumvit Hospital provides comprehensive gynecological and obstetrical service for women of all ages.

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