What is behind the link between fertility problems and endometriosis?

The link between fertility problems and endometriosis can be that severe endometriosis causes pelvic scarring and distortion of pelvic anatomy. The tubes can become damaged or blocked and the ovaries often contain cysts of endometriosis (endometriomas) and may become adherent to the uterus, bowel or pelvic side wall. Any of these anatomic distortions can result in infertility.
Experts are not sure exactly why endometriosis lowers a woman's fertility. One theory that's getting a lot of attention suggests it may be related to an underlying immune condition that increases inflammation. Inflammation is caused, in part, by chemicals called cytokines, released when the immune system sweeps in to fix a problem. Endometrial tissue outside the uterus is certainly one of those problems! And, in fact, studies find higher levels of cytokines in the fluid within the peritoneum, which encloses the gastrointestinal and reproductive organs. Other studies suggest that high levels of cytokines can negatively affect not only fertility, but the outcome of pregnancy and the health of embryos. Cytokines can also affect the health of your eggs, with studies finding that women with endometriosis have more problems related to their ability to produce healthy eggs than those without. Unhealthy eggs are much less likely to lead to a pregnancy even if a sperm reaches them.

The inflammatory theory also gets support from baboon studies, which found endometriosis and endometriosis-related infertility improved when the animals received anti-inflammatory treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.