What Is Endometriosis?

Endometriosis is a disease in which cells similar to those that line the uterus may grow elsewhere in the body, such as the ovaries and fallopian tubes, resulting in extremely painful periods and sometimes causing infertility. 

Endometriosis causes distortion of the pelvis and the release of inflammatory markers: macrophages and cytokines. But the impact of endometriosis goes beyond this.

How Is Endometriosis Diagnosed?

Endometriosis can be very difficult to diagnose. As a part of diagnosis an ultrasound, followed by an MRI and CA-125 blood tests which may be performed, though Endometriosis can only be definitively determined by laparoscopic surgery.

Advances have been made for non-invasive testing.  The ReceptivaDx™ test, is a first of its kind test for the detection of inflammation of the uterine lining most commonly associated with endometriosis. 

How Does Endometriosis Impact My Fertility?

Endometriosis can affect your Ovarian reserve and normal egg development by…

  • The mitochondrial content of eggs can be distorted causing cytoplasmic granulation: breakdown of the cytoplasm.
  • Abnormal spindle formation in the egg.
  • Hardening of the zona pellucida: the outer shell of the egg.

All of these factors can impact the result of fertilisation, embryonic development and ultimately implantation.

Endometriosis can affect your implantation and carrying a pregnancy to term by…

  • Raising Inflammatory markers in your uterine cavity which cause an inhospitable environment for your healthy embryos.  

Endometriosis can affect the DNA structure of the cells that line your uterus…

A recent study has shown that women with endometriosis may have epigenetic differences compared to women without the disease. Genomes of endometrium cells in women with and without endometriosis were assessed and differences in the patterns of DNA methylation were identified. Methylation is a chemical change to the DNA that influences which genes are turned on and off. These changes could play a role in the infertility that often accompanies endometriosis.

The DNA methylation patterns of endometrial stromal fibroblast cells were compared in women with early (stage I) or late (stage IV) endometriosis and women without endometriosis. The data showed that these patterns were different in each of these conditions, indicating that there may be two disease subtypes, rather than progressive stages of the disease!

What Fertility Treatments Are Recommended If You Have Endometriosis?

The severity of your endometriosis will ultimately decide the level of treatment. Those suffering from stage 3 or 4 (Severe) endometriosis, will be advised that IVF is the first choice of treatment. 

If you have been diagnosed with endometriosis and are not yet ready to have a baby, it would be a good idea to consider egg freezing (before the disorder progresses). 

Some studies have shown that antioxidants may mitigate the damage to our eggs. N-acetyl cystein (NAC) and other antioxidants may decrease the chance of chromosome and spindle misalignments in eggs and embryos.