- Welcome to Fertile Minds.
I'm Dr. Raewyn Teirney, CREI fertility specialist
with IVF Australia.
What causes endometriosis?
Well, we're not exactly clear on what causes endometriosis.
We know that about one in 10 women have endometriosis.
There are a few theories around as to the nature
of the cause of endometriosis.
And the top three theories,
the first one is Sampson's theory
and this is retrograde menstruation.
And the theory goes that when we bleed,
blood cells, the uterine cells and endometrial cells,
can retrograde, flow backwards from the uterus
through your fallopian tubes into your pelvis.
And those endometrial cells
can then implant into the uterus.
And this is one theory.
There is another theory called coelomic metaplasia
and here it is where cells that are on your tissues
in the pelvis undergo some form of change
where they change from one cell into an endometrial cell,
and then start growing
and implanting under the influence
of the female hormone, estrogen.
A third theory is an immune theory,
and it is based on your altered immunity
that somehow doesn't pick up
that there are these cells here
because our immune system usually knows
if there's something wrong
and can then take it out of the system.
However, when there's altered immunity,
it allows for these endometrial cells
to implant further
and extend further causing quite severe endometriosis.
So these are three possible theories
but really are not clear.
How does endometriosis affect fertility?
There are a variety of ways.
When you have endometriosis
what can happen is it can distort the tissues
within your pelvis.
So it can block fallopian tubes
and therefore prevent egg and sperm from meeting.
It can distort the anatomy where the fallopian tube
cannot even pick up the ovulated egg.
It can also distort the ovary
and form a cyst within the ovary preventing ovulation
or the ovulated egg from coming out as well.
This tends to be the more severe endometriosis.
In cases where there is only mild endometriosis,
where there are just a few spots
and there is no distortion of anatomy,
well, then how does it cause infertility then?
And some of the theories are based on special mediators
that are released by the endometriosis
that can have some detrimental factor
on egg and sperm interaction
and possibly even affect implantation.
Again, these are all theories
with the stage one and stage two endometriosis,
but certainly we know it does affect a person's fertility.
And you need to speak to your doctor further about that
if you suspect you might have endometriosis.
Often asked, does the diagnosis of endometriosis
automatically mean that, I'll be in fertile?
Well in fact, that's not the case at all.
And many women with endometriosis do go on
to conceive naturally.
However, if you have endometriosis
and you're under the age of 35
and you've been trying for longer than 12 months,
then certainly you do need to see your fertility specialist
and seek help.
Even more so, if you're over the age of 35
and you have endometriosis and you're trying to get pregnant
and you haven't been successful
for the past six months or longer,
then you too must seek specialist fertility help
and advice around that.
So when it comes to infertility
or when it comes to endometriosis,
there are some treatment options.
And none of this means that you'll be infertile.
Some treatment options would include just surgery.
And many women only require a laparoscopic surgery
to remove endometriosis.
And then many go on to conceive
within the next six months after that.
However some women may need fertility treatment
to help them conceive.
And IVF has certainly a great fertility treatment
for women with endometriosis.
And so will you always be infertile?
The answer is no,
because there are certainly very good treatments out there
to help women with endometriosis conceive.
If you suspect that you might have endometriosis,
then my advice to you would be to seek help earlier.
Don't wait.
I would go and either visit your family doctor
or a specialist gynecologist.
Sit down with them, let them take your history,
possibly examine you and organize for further testing
such as a pelvic scan and blood tests.
And the reason why you want to seek help is,
because if you do have endometriosis,
treatment can occur much earlier.
And that can be started pretty quickly.
And especially if you're someone who may be having pain,
then pain management can occur
and start earlier for you.
If you're someone who is trying to get pregnant
and you think you might have endometriosis,
that even this is an even better reason
why you should be seeking help earlier
and seeing your doctor or fertility specialist.
I hope you found this video helpful.
And always remember that fertility specialists
like myself are here to help provide support
and guidance for you.
Thanks for watching.
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