Most cases of endometriosis are mild, and the 5-10% of affected women have no infertility issues related to their condition. Yet, 30-40% of infertile women do have endometriosis, so there’s a statistical connection between endometriosis and infertility, though a causal relationship isn’t yet established in mild cases, which sometimes have no effect on fertility.
Severe endometriosis, however, is another matter. Advanced cases can cause scarring of the reproductive organs. This scarring leads to distortions of the fallopian tubes or ovarian cysts, both of which can interfere with fertility. Blockages of the fallopian tubes prevent fertilization, and ovarian cysts may damage viable eggs.
Endometriosis may also produce substances that inhibit egg movement, and pelvic inflammation stimulates the production of cells that attack and kill sperm when present in your body.
When mild endometriosis is symptomatic and thought to be causing infertility, drug treatment can suppress its effects while also relieving pain, as can laparoscopic removal of endometriosis lesions. Though there’s some encouraging research underway, these procedures aren’t yet conclusively shown to improve fertility. Ovarian hyperstimulation combined with intrauterine insemination are typically treatments in cases of mild to moderate endometriosis, in the absence of other infertility factors.
For more severe cases of endometriosis, surgical solutions may provide results, but much depends on the extent of scarring and distortions in each case. Since endometrial tissue may settle nearly anywhere in the pelvis, there can be great disparity between patients that may interfere with the effectiveness of surgical procedures.
Ovarian endometriosis cysts have three main treatments, two variations of draining the cysts and laparoscopic removal. There is some evidence that removing cysts larger than 4 centimeters improves fertility rates, though some egg follicles may be removed or damaged during the procedure.
Again, the success of other treatment methods such as in vitro fertilization is variable, depending on the details of your specific case. If Dr. Bozdogan can harvest your eggs and they are undamaged, the success of in vitro methods may depend on the endometrial damage to your uterine walls.