Endometriosis often doesn’t cause symptoms. Even though you may not know you have endometriosis, it’s causing damage: 30-50% of women with endometriosis can’t get pregnant, making this condition one of the top causes of infertility. The experienced doctors at New York Fertility Institute provide comprehensive care for endometriosis, treating your endometriosis and also offering their expertise in procedures to overcome infertility when needed. If you suffer symptoms such as pelvic pain or you can’t get pregnant, call the New York City office in Manhattan’s Upper East Side or schedule an appointment online.
Endometriosis occurs when tissues like those that normally line the uterus grow outside the uterine cavity. Patches of endometriosis most often grow on your fallopian tubes, ovaries, and the outer wall of the uterus. Though not as common, endometriosis may grow on your bladder, bowel, and connective tissues in your abdomen.
Laparoscopy is performed in our office under general anesthesia with minimal discomfort. It is a procedure by which the laparoscope (a telescope-like instrument) is placed through the umbilicus, allowing for visualization of the pelvic and abdominal cavity. Operative laparoscopy involves placement of the instrument through secondary incisions to correct conditions such as pelvic adhesions, blocked fallopian tubes, removal of endometriosis implants, and removal of ovarian cysts and endometriomas. Laser and electrocoagulation are utilized through laparoscopy.
The uterine lining, called the endometrium, responds to hormones that make it thicken with a rich supply of blood so it can nurture an embryo. If you don’t become pregnant, the lining sheds in the form of your monthly period.
The areas of endometriosis outside your uterus also thicken and break down each month. The blood, however, remains in the abdominal cavity, where it causes inflammation, scarring, adhesions, and, in some cases, cysts.
Many women don’t develop symptoms. You can have severe endometriosis and not have any signs of a problem. Or you could have mild endometriosis and severe symptoms.
When symptoms appear, you experience one or more of the following.
In addition to pain, your menstrual periods may be heavier or longer than normal.
Scar tissue and adhesions distort your reproductive anatomy. These changes may prevent pregnancy by blocking the fallopian tubes and distorting the shape of the uterus. Chronic inflammation may affect the quality of your eggs or limit fallopian tube movements that help move an egg through the tube.
Additionally, endometriosis may affect hormone levels, leading to imbalances that cause infertility. Women with endometriosis may have higher than normal levels of certain types of immune cells, which may impact your ability to become pregnant.
The first line of treatment for endometriosis is hormonal medications such as birth control pills to minimize menstrual periods and relieve your symptoms. The next step is surgery to remove the patches of endometriosis, adhesions, scar tissues, and cysts that may have formed.
If you have mild endometriosis or you can’t get pregnant after surgery, your New York Fertility Institute provider may recommend ovarian stimulation and intrauterine insemination to place sperm into your uterus at the time of ovulation.
In-vitro fertilization (IVF) is another effective treatment option. During IVF, your eggs are retrieved and fertilized in the onsite lab. After several days, the embryo is then gently implanted into your uterus.
Ovarian endometriomas are successfully treated by sclerotherapy which will preserve the oocytes.
During ovarian cystectomy for endometriosis, oocytes may be damaged and diminished, therefore, sclerotherapy is a novel approach for treating ovarian endometriomas and preservation of oocytes.
If you develop pelvic pain or have a hard time getting pregnant, call New York Fertility Institute or schedule an appointment online to see if endometriosis is the cause and get treatment.