ENDOMETRIOSIS – NO LONGER AN ENIGMA !!
What is endometriosis
Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis is most commonly found on other organs of the pelvis.
Common symptoms of Endometriosis
- Pelvic pain that may worsen during menstruation
- Painful intercourse
- Painful bowel movements or urination
Endometriosis and Infertility
Endometriosis is more common in infertile women. as opposed to those who have conceived a pregnancy.( delete this ). However, many women with confirmed endometriosis are able to conceive without much difficulty, particularly if the disease is mild or moderate. The reasons for a decrease in fertility when endometriosis is present is because it may incite significant adhesion formation within the pelvis which can distort normal anatomical structures. Alternatively, endometriosis may affect fertility through the production of inflammatory substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo.
How to find out if one has Endometriosis and the treatment modality
In one such case , an ultrasonography confirmed the presence of 6 cms cysts on both sides and antral follicle count (AFC ) of 3 + 3. Blood test of Anti Mullerian Hormone (AMH ) showed a low reserve of 1.2. AFC and AMH are basically done to assess the egg reserve capacity in the ovary which will give an idea about the baseline status before any treatment is offered. Hormonal treatments are given to those with painful and heavy periods to reduce or stop ovulation thus allowing the endometriosis to shrink. But these cannot be prescribed for women who are keen to have a baby. The best suggestion is to remove the cysts and proceed with the fertility treatment. Laser treatment of endometriosis is also very popular because the affected tissues may be removed without touching the good tissues.
A laparoscopy was done and both the endometriotic cysts were removed carefully. The patient was programmed for IVF due to bilateral tubal block. Subsequently she conceived and delivered a healthy baby.
Not all patients with endometriosis require laparoscopy or IVF. Women with Grade I or II but with normal tubes are likely to conceive with medical intervention to induce ovulation along with IUI, while those with Grade III or IV may need IVF .