Endometriosis is one of the most common gynaecological conditions affecting women in Australia, and is also recognised as one of the more frequent contributors to fertility difficulties. If you've been diagnosed with endometriosis – or suspect you may have it – and are concerned about what this means for your fertility, you're not alone, and there is a great deal that can be done. Dr Mandana Master provides specialist, compassionate care for women navigating endometriosis and fertility, helping you understand your options and move forward with confidence.
Endometriosis is a chronic inflammatory condition in which tissue similar to the lining of the uterus grows outside the uterus, most commonly on the ovaries, fallopian tubes, and other structures within the pelvis. Like the uterine lining itself, this tissue responds to hormonal changes throughout the menstrual cycle, which can lead to inflammation, pain, and over time, the formation of scar tissue and adhesions.
Endometriosis can affect women very differently. Some experience severe pain and heavy periods, while others have few or no obvious symptoms and are only diagnosed during fertility investigations. Common symptoms include pelvic pain, particularly around menstruation, pain during intercourse, heavy or irregular bleeding, bowel or bladder discomfort, and fatigue, though the severity of symptoms doesn’t always correspond to the severity of the disease itself.
Endometriosis can affect fertility in several different ways, with the impact varying considerably from woman to woman depending on the location, extent, and severity of the condition.
Ongoing inflammation can lead to the formation of scar tissue and adhesions, which may distort the normal anatomy of the pelvis. This can affect the position and function of the ovaries and fallopian tubes, making it more difficult for an egg and sperm to meet.
In some cases, endometriosis deposits can partially or fully block the fallopian tubes, preventing the transport of eggs and sperm and reducing the likelihood of natural conception.
Endometriosis can sometimes form cysts on the ovaries, known as endometriomas. These can affect ovarian reserve – either through the condition itself or as a result of surgery to remove them – which may reduce the number of eggs available for natural conception or future fertility treatment.
There is growing evidence that the inflammatory environment created by endometriosis may affect egg quality and the early development of embryos, even in the absence of any structural damage to the reproductive organs.
Some research suggests that endometriosis may alter the lining of the uterus in ways that make it more difficult for an embryo to implant successfully, although this remains an area of ongoing research.
The physical and psychological toll of chronic pain from endometriosis can affect sexual function and intimacy, reducing your chances of conception.
It’s important to know that not every woman with endometriosis will experience fertility difficulties, and the relationship between the two is not always straightforward. Many women with endometriosis conceive naturally, while others benefit significantly from specialist input and treatment. Dr Mandana will assess your individual circumstances to understand how endometriosis may be affecting you specifically, rather than assuming a one-size-fits-all impact.
Diagnosis of endometriosis can be challenging, due to the non-specific symptoms of endometriosis and the fact that period pain is often normalised and dismissed. If your symptoms indicate endometriosis may be playing a part in your difficulties conceiving, you may undergo diagnostic tests for endometriosis such as:
To identify endometriomas or other visible signs of disease.
For more detailed imaging in suspected deep infiltrating endometriosis or dense adhesions.
A minimally invasive surgical procedure that remains the gold standard for definitively diagnosing endometriosis, and can also be used to treat it at the same time.
Including anti-Müllerian hormone blood tests, particularly important if endometriomas are present or surgery is being considered.
To remove or treat endometriosis lesions and adhesions, which can improve the chances of natural conception for some women.
To manage pain and symptoms, although hormone-based medications are usually avoided when actively trying to conceive.
Including IUI or IVF, which can help bypass some of the fertility barriers caused by endometriosis, particularly where surgery alone hasn’t been successful.
Fertility preservation may be considered if you are diagnosed with endometriosis but are not yet ready to start a family. Egg or embryo freezing can help to preserve your future reproductive potential, particularly where endometriomas or planned surgery may affect your ovarian reserve.
Dr Mandana will work closely with you to determine which combination of treatments is most likely to support your fertility goals, taking into account your symptoms, the extent of your endometriosis, and your future family-building plans.
If you need specialist advice and care for achieving your family building goals, you’ve come to the right place. Get in touch with Dr Mandana Master at Embrace Fertility today.
