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Endometriosis

Endometriosis – a chronic disorder that can cause infertility

Endometriosis is a chronic but benign gynaecological disorder that occurs in women of childbearing age. With endometriosis, tissue resembling the lining of the womb (the endometrium) grows in one or more organs. For example, it could be found in the womb, the fallopian tubes, the ovaries as well as the peritoneum, the intestines and the bladder. These areas of tissue, called endometrial tissue, grow and can bleed, so an inflammatory-type condition develops in the tissue and over time forms scar tissue. These tissue changes hinder fertilisation and implantation of the fertilised egg. 

Symptoms of endometriosis: Similar to the changes that take place in the endometrium, endometrial tissue undergoes cyclical changes, which typically leads to pain in connection with the earlier stages of the disorder, i.e. in the beginning. When the disorder has been present for some time, the pain often becomes more chronic and will not be related to menstruation. The pain may also be provoked by intercourse.

In some cases endometriosis is diagnosed when the women in being investigated for infertility. The range of symptoms can vary greatly from one woman to another, and their extent does not necessarily coincide with whether a woman has a lot of symptoms.

What are the causes of this complaint?

The causes of endometriosis are not fully understood. There are various theories about how the tissue changes occur. These may include:

  • Part of the endometrium is carried into the pelvic organs as backward menstrual flow (retrograde menstruation)
  • Parts of the endometrium are transported via the blood and lymph vessels
  • Genetic factors that trigger tissue changes
  • Immune system dysfunction
  • Environmental effects, particularly toxins such as PCB, DDT and dioxins that affect the endocrine system

Because of the many different symptoms and the complex nature of the disorder, it is obvious to assume that the condition is not due to just one cause. It is assumed that there is a combination of different factors at play.

How is the condition treated?

There are several treatment options for infertile patients with endometriosis. The condition can be treated medically, surgically or with a combination of medical and surgical treatment. This will be decided during the initial consultation. A thorough diagnosis should be made and our specialists should provide counselling so that individual treatment for each patient can be determined. 

Whether this is insemination or IVF depends on the extent of the endometriosis and whether there are any other conditions affecting fertility that should be taken into account.

Diagnosis: To make a diagnosis, an ultrasound scan is normally done first, and if necessary, a laparoscopy (keyhole examination of the abdomen). Minor areas of endometriosis can be removed immediately during laparoscopy.

If large tissue changes or adhesions are found in areas that are difficult to access, a bigger operation (a laparotomy) may be necessary.

Protection of the organs is the top priority in infertile patients. This means that large areas of endometriosis in the womb or fallopian tubes cannot always be completely removed. Therefore, medical treatment may be subsequently commenced that keeps the endometriosis at bay until fertility treatment is started. 

Endometriosis – facts and figures

  • Endometriosis is the second commonest gynaecological disorder after myomas (benign fibroids) in the womb.
  • Between 7 and 15% of all women of childbearing age, many of whom are undiagnosed, are thought to have endometriosis.
  • It is estimated that 40,000 new cases of endometriosis arise every year.
  • Endometriosis is often not picked up for a long time. On average, it can take six years from the onset of symptoms to getting a diagnosis.
  • Endometriosis patients are divided into infertile patients with a fertility disorder due to an illness and patients with pain who are not involuntarily childless but who are suffering from the physical symptoms of the disorder.

Information about endometriosis can be found online, e.g. den danske forening for endometriosis [The Danish Association for Endometriosis]: www.endo.dk.

Source: Stiftung Endometriose-Forschung, [The Foundation of Endometrial Research, Germany]

We are here for you!

Please feel free to contact us!

Our opening times:

Mon and Thu: 08:00 - 18:00
Tue, Wed and Fri: 08:00 - 16:00
Sat, Sun and holiday: 08:30 - 15:00

Schedule an appointment:

Fill out the contact form

✉ info[at]storkklinik.dk
+45 32 57 33 16

We look forward to hearing from you!