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Endometriosis: a chronic disorder causing infertility

Endometriosis is a chronic, benign condition in the abdominal cavity, which generally takes place in women of fertile age. It involves tissue which looks like endometrial tissue growing on one or several organs. It can occur on the uterus, fallopian tubes or ovaries, but also on the peritoneum, intestines or bladder. This growth can evolve into endometriosis lesions, which behave like the endometrium. During the menstrual cycle, this causes them to grow under the influence of hormones, and lesions may bleed during menstruation. After a while, the peritoneum and organs will become irritated and scar tissue will develop. If the endometriosis is severe, adhesions or growths may develop. These tissue changes will make conception as well as embryo development more difficult.

What are the causes of endometriosis?

Doctors are not not sure of the exact cause of endometriosis. Several theories regarding tissue changes are listed below.

  • Endometrial cells may move to the organs in the abdominal cavity through retrograde menstruation (the reverse flow of menstruation) to the abdominal cavity.
  • Endometrial cells may move through blood or lymph vessels.
  • Genetic factors may cause tissue change.
  • Decreased functioning of the immune system.
  • Environmental factors: especially toxins such as PCBs, DDT or dioxin, which cause changes in the hormonal system.

The diverse range of symptoms, as well as the complex progression of endometriosis indicate that there may not be a singular cause for the development of this condition. Rather, a combination of several factors may be responsible.

Symptoms of endometriosis

The symptoms of endometriosis are incredibly diverse and don’t always correlate directly to the severity or spread of the disease. Relatively common are menstrual issues, such as persistent abdominal or backaches, heavy bleeding, discomfort during ovulation, discomfort during intercourse or discomfort during gynecological examinations. Inability to conceive, too, is a common consequence of this disease. The cause of this is the adhesions in the abdominal cavity which make the transport of sperm cells through the fallopian tubes as well as the reception of oocytes from the fallopian tubes more difficult. 


Endometriosis is diagnosed through analysis of patients’ symptoms, further physical examinations, blood testing and, in some cases, using an MRI or laparoscopy. Small endometriosis lesions can be removed during a laparoscopy using, for instance, laser treatments or electrosurgery. 

How is endometriosis treated?

The treatment of endometriosis is often hard for women who want to have children. Endometriosis is usually treated by pausing the menstrual cycle. This allows the endometriosis to calm down. However, pausing the menstrual cycle is not an option if the afflicted person wants to have a child.

Depending on your symptoms, the best course of action for someone who is suffering from a mild form of endometriosis may be to remove all visible endometriosis lesions during a laparoscopy. After that, we can wait to see whether pregnancy will occur naturally. For someone who is suffering from a more aggressive or severe form of endometriosis, we may advise using an IVF treatment to increase your chances of a successful pregnancy.

Before endometriosis treatment is started, extensive examinations will take place and you’ll have some consultations with our specialists. This will help to determine the individual treatment goals for each patient’s unique situation.

Endometriosis: facts and figures

  • After myomas (fibroids), a kind of benign tumor, endometriosis is the most common gynecological disorder.
  • Roughly 1 in 10 women experience endometriosis during their fertile period. The disease is never officially diagnosed in many of them, though.
  • The number of new endometriosis cases each year is estimated to be 40.000.
  • It often takes a long time to officially diagnose endometriosis: on average, it takes six years to get from the first symptoms to a diagnosis.
  • The severity of the symptoms does usually not correlate directly to the actual severity of endometriosis.