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APPOINTMENT

Fertility Evaluation

Endometriosis

This is a highly common condition in which tissue lining the uterus (endometrium) grows outside the uterus, into such areas as the ovaries, fallopian tubes, the area between the vagina and rectum and the lining of the pelvic cavity. During menstruation, this excess endometrial tissue bleeds just as if it were normal tissue. Unlike normal tissue, however, it is not shed from the body, but instead becomes fixed to the area. This eventually causes inflammation, pain and scarring of the fallopian tubes, ovaries and surrounding reproductive anatomy.

Diagnosing Endometriosis

This involves an examination in which a doctor will assess frequent symptoms of endometriosis including:

Pain before and during periods

Endometriosis
  • Pain with sex
  • Infertility
  • Fatigue
  • Painful urination during periods
  • Painful bowel movements during periods
  • Other Gastrointestinal upsets such as diarrhea, constipation, nausea.

A minimally invasive surgery called laparoscopy uses a thin, lighted viewing instrument (laparoscope). The laparoscope is inserted into the pelvic area through a tiny incision made in the belly button. This process allows the doctor to look at endometrial tissue in the reproductive area. The laparoscope can also be used to surgically remove endometrial tissue.

On ultrasound, sometimes we can see cysts filled with cloudy fluid within the ovary. These cysts are filled with old blood and known as "chocolate cysts" as the old blood looks a lot like chocolate syrup. If we see these characteristic cysts on ultrasound, we will diagnose endometriosis. Moreover, surgery is required if there is significant pelvic pain. Some advocate removal of cysts if they show signs of growth over time or for cysts larger than 5 centimeters

In most cases of more severe and extensive endometriosis, we will advocate in vitro fertilization, to help get the eggs, sperm and embryos out of the pelvic environment, which has been shown to be toxic to these cells.

We employ a multi-faced treatment approach and work together to create a personalized treatment plan for each patient.

Some common endometriosis questions include:

  • What are some of the warning signs for endometriosis?
  • What are the best fertility treatment options for endometriosis?
  • How much will endometriosis affect my chances of getting pregnant?

And much more... We're here to answer your questions.