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Endometriosis: Understanding unexplained infertility


For couples, when it takes longer than usual to get pregnant, the first thing you want to know is why. So you go to the doctor and run all series of tests, to researching family medical history to physical examinations and everything else in between—and still nothing. What exactly is the problem then? About 30 % of people that experience infertility challenges have been diagnosed with ‘Unexplained Infertility’. Although this may sound like good news because obviously, it is better to find nothing wrong than to find something seriously wrong, a diagnosis of unexplained infertility can be rather frustrating because the guessing game becomes endless.

However, new information has to come to the fore that suggests many of these unexplained cases can actually be explained. Renowned Physician Dr Norbert Gleicher put it best by saying “‘Unexplained’ Infertility generally means that the physician failed to find its true cause.” It could be anything; it could be nothing; it could be Endometriosis.

Endometriosis is a reproductive organ disorder believed to affect roughly 176 million women; that’s an estimated 10% of women worldwide. Endometriosis classically presents in women in their twenties to early thirties. Signs and symptoms include dysmenorrhea (very painful menstrual periods), dyspareunia (painful sexual intercourse) dysphasia (painful bowel movements) and infertility. Other symptoms of endometriosis include IBS symptoms such as constipation, diarrhea, bloating. People with endometriosis may also experience back pain, nausea, weakness and fatigue. Usually the pain associated with endometriosis is almost unbearable except for a very lucky few who have minimal pain.


Young girls are taught that they would experience some pain and cramping during their periods and hence tend to be quiet about it. We need to correct that notion. Young girls, if you are experiencing severe crippling pain during your periods, please see a doctor to discuss your symptoms. These are probably signs and symptoms that most likely indicate that there may be a more serious underlying condition. The signs and symptoms of endometriosis are so vague and widespread that often times, it takes an average of about 10 years for a diagnosis of endometriosis to be made, and most times by the time it is diagnosed, there might be widespread inflammation in the reproductive organs; that would substantially decrease fertility.

Endometriosis is the abnormal growth of endometrial tissue occurs outside of the uterine cavity which causes widespread inflammation, scar tissue formation, reproductive blockages, fertility problems, severe pain etc. The true diagnosis for endometriosis is made by direct visualization of these endometrial implants through laparoscopy (a surgical procedure in which an instrument is inserted through a small incision in the abdomen to help view organs in the abdomen).

Recent research shows endometriosis is characterized by free radical stress; there is an increase in reactive oxygen species (ROS) in the pelvic cavity in women with endometriosis. Scientists believe it results from numerous factors including increased red blood cells, cellular debris from retrograde (reverse) menstruation, degrading tissue, high macrophage activity (immune eater cells) or a combination of these factors. Additionally, the body’s natural ability to produce antioxidants and detoxify itself may be compromised in some women with endometriosis, worsening the problem.

Treatment options include taking pain medications such as Ibuprofen to help with the pain. Hormonal therapy with drugs that help to decrease the formation of these foreign endometrial implants. Excision surgery is the best option because surgery would help cut off all the endometrial implants and adhesions which will help restore normal pelvic anatomy. By doing this early, women with endometriosis would still have a great chance at preserving their fertility and be capable of bearing children. In addition to these conventional treatments, current research suggests that antioxidants may also be critical to help stop the inflammatory cascade that ignites endometriosis and would help to restore fertility health. Antioxidant supplements have been shown to be beneficial. Also, you have to be mindful of your diets. There are many foods that contribute to the spread and pain of endometriosis; Choose foods that support estrogen metabolism and reduce inflammation. Nutrition is very important when it comes to endometriosis.

If you or someone you know has been diagnosed with unexplained infertility to ensure that your fertility doctor has not missed possible endometriosis. It is important to be able to recognize the signs and symptoms; not just for ourselves, but also for the young teenage girls that are still growing. Correcting a misdiagnosis could be the key to solving your Infertility issue and experiencing a return to optimal fertility.

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