Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside it, on the ovaries, the tubes, the bowel and the lining of the pelvis. It can cause painful periods, pain during sex and scarring, and it is found in a significant share of people having trouble conceiving.

Where you'll meet it

Many people first meet it as a suspicion, after years of pain that was brushed off as normal periods. A scan can show cysts on the ovaries, known as endometriomas, and deeper nodules. Mild disease is often invisible on a scan and is only seen, and confirmed, at a laparoscopy.

How it affects fertility

It can distort the tubes and ovaries with scarring, inflame the pelvis, and in the case of ovarian cysts reduce the number of eggs available. How much it matters varies enormously. Plenty of people with endometriosis conceive without any help.

What can be done

Keyhole surgery to remove or destroy the deposits can improve the chance of natural conception, especially in milder disease. IVF works around it, and for many people with more advanced endometriosis or other factors it is the most direct route. Surgery on ovarian cysts deserves careful planning, because it can lower ovarian reserve, so ask about freezing eggs first if your reserve is already low.

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