Many women who present with infertility also have a disease called endometriosis. Endometriosis is a condition in which the uterine lining, also known as the endometrium, implants in places other than the uterus. It can implant places like the ovaries, the fallopian tubes, or the bowl, and in rare cases even go up in places like the lung. That doesn't happen very often, but in general endometriosis tends to spread. Most cases are, however, limited to the pelvis. About one in three women who presents with infertility does have endometriosis, and about one in three women with endometriosis have infertility.
Endometriosis is diagnosed by laparoscopy. A telescope is placed into the belly button under anesthesia, and a camera and light source are used. And the contents of the pelvis are manipulated to look under the different surfaces of the uterus, the ovaries, the Fallopian tubes, and the bowel. Endometriosis can be treated either surgically or medically in certain cases. In cases, however, in which fertility is the problem, surgery has been shown to be more effective than medical treatment. Surgery can include abrading the lesions, either using heat or other types of energy, or also the lesions can be excised surgically. Scar tissue that results as a result of endometriosis can be liced, and Fallopian tubes repaired in certain cases.
Not all cases of endometriosis, however, are able to be treated effectively. In many cases, the endometriosis itself may case less problems with fertility than previously anticipated. In those cases, you just go right into medical treatments, or in vitro fertilization or inseminations in some cases, in order to achieve pregnancy.
In women who present with severe pelvic pain, which is one of the most common symptoms of endometriosis and infertility, surgery is the right treatment. In cases in which the woman is not trying to get pregnant but has just pain, medical treatment might be equally effective. Endometriosis is an important disorder, is treatable in many cases, and is important to address in any couple that is undergoing fertility treatment.