This article explores the complex relationship between endometriosis and infertility. It delves into the various ways endometriosis can impact fertility, discusses the prevalence of infertility among women with endometriosis, and highlights the importance of early diagnosis and personalized treatment approaches.
When Jess Taylor was diagnosed with endometriosis at 20, she was worried becoming a mother might not happen for her. 'The grief you go through is significant,' she says. 'You think 'my body as a woman is built to grow babies', and now I'm being told that I can't do that — that is very overwhelming.' Ms Taylor, who has since become a mum, says her experiences inspired her to help other women navigate the disease, including its impact on fertility.
She took on the job of CEO for QENDO, an organisation advocating for people with endometriosis and other pelvic-health-related conditions. \We explain why the disease can make it hard to get pregnant, and how prevalent infertility is for people with the condition. CEO of QENDO, an organisation advocating for people with endometriosis and other pelvic-health-related conditions, is also a public health researcher at the University of Queensland with an interest in reproductive health and assisted reproductive technology. \It's not always known how endometriosis is impacting someone's fertility, explains Katrina Moss, a public health researcher at the University of Queensland, with an interest in reproductive health and assisted reproductive technology. But Dr Moss says there are several ways the disease can hinder natural conception, such as inflammation impacting endometrial receptivity (a process that provides the embryo the opportunity to attach, invade, and develop), as well as egg formation and ovulation. Endometriosis can block the fallopian tubes, and impact the hormonal balance of the ovaries. 'If they have endo lesions across their ovaries or fallopian tubes, then they may have a more increased chance of fertility issues.' Dr Moss says surgery to remove endometrial lesions on the ovaries can affect ovarian reserve (the quantity and quality of eggs remaining in a person's ovaries) and response to ovarian stimulation in fertility treatment. \Photo shows A woman with long black hair leaning against a brick wall. On top of already painful symptoms, many women with endometriosis from multicultural backgrounds face cultural pressures to start a family after marriage. Most people with endometriosis won't have trouble conceiving, says Dr Moss. 'It's around 40 per cent of women with endometriosis who will have trouble conceiving, that means 60 per cent won't.' However stats can be 'tricky', she explains, because most of the data is based on people who have an endometriosis diagnosis. 'But we know a lot more women have endo ,' she says, adding a diagnosis can take a long time (Dr Moss works on the Australian Longitudinal Study for Women's Health, and as part of that followed a cohort of Australia women for more than 25 years. She has mainly worked with the group born between 1973 and 1978, who are now in their mid to late 40s. 'It's a good cohort to look at because we've got really good survey data, and we know they are at the end of their reproductive years,' she says. One study that involved 8,241 of those women found 12 per cent had endometriosis. Of the women who were diagnosed with the disease, 47 per cent said they had trouble trying to conceive. It was 67 per cent for women who had both endometriosis and PCOS. 'If we look at women with endo, their difficulty conceiving is twice the rate of people without either, so it's definitely elevated,' Dr Moss says. Ms Taylor says the most accepted rate of infertility in people with endometriosis is 30 to 50 per cent. From Kate Young at the Queensland University of Technology says research with larger samples typically finds about 10 to 15 per cent of women diagnosed with endometriosis are also diagnosed with infertility. \Why experts say the egg timer test is being misused. Women like Libby French are using the egg timer test to make high-stakes decisions about their fertility, but experts say it's not a reliable predictor of reproduction potential. Treatment for endometriosis is multi-disciplinary. What treatment someone has, and results they get when trying to address infertility will be very individual, says Ms Taylor. 'A lot of women find they do go have a laparoscopy, remove some scar tissue or adhesions and … find they can. For women who find sexual intercourse painful, a pelvic health physio may also help with trying to conceive, Ms Taylor says as another example. For those who do have trouble conceiving due to endometriosis, Dr Moss says, 'early diagnosis is the key.' People who had undiagnosed endometriosis were disadvantaged during fertility treatment. 'People who knew about their endo followed a different treatment path: they did fewer cycles and were more likely to go straight to IVF rather than starting with IUI , which may be more effective for women with endometriosis.' She says the study showed people who knew about their endometriosis before fertility treatment had the same success rate as people with other causes of infertility
Endometriosis Infertility Reproductive Health Diagnosis Treatment PCOS
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