Endometriosis, a disease that may produce infertility

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Endometriosis, a disease that may produce infertility

Dr. Juan Francisco Solís Bercián
Medical Director Santa María Clinic
Center Specialized in Reproductive Medicine
MULTIMEDICA VISTA HERMOSA

Endometriosis is a common disorder that affects woman during her reproductive life, which occurs when the tissue lining the uterine cavity grows out of it. This tissue can grow in superficial small “patches” (known as implants), in thicker, penetrating nodules, or may form cysts in the ovary, called endometriomas. During each menstruation, these foci of endometriosis also bleed, creating an inflammatory environment in the pelvis.

Endometriosis is highly unpredictable. Some women can have just one or two isolated implants that never disseminate or grow, while in others the disease may spread throughout the pelvis. Such a condition irritates the surrounding tissue and may promote the growth ofadherences, scar tissue in the shape of a spider web. This scar tissue can join any of the pelvic organs together and in some occasions may even cover them completely.

Signs and Symptoms. Many women that suffer from endometriosis experiment few symptoms or may even not have any. In fact, endometriosis is often diagnosed when pelvic surgery is done for other reasons. However, in some women, endometriosis may cause severe menstrual cramps, pain during sexual intercourse and infertility, among other symptoms.

Diagnosis. The diagnosis of this disease is done by direct visualization of the lesions, usually through a pelvic video laparoscopy (See figure 1). Other diagnostic tests, among them the ultrasound, de CT Scan and magnetic resonance, may suggest the existence of the disease, but the diagnosis is confirmed only by direct visualization of the lesions in the pelvis by means of the video laparoscopy.

Treatment. Endometriosis can be treated with medication or with video surgery with the purpose of preserving fertility. In the cases where endometriosis affects fertility (impossibility to conceive), treatment options range from surgical techniques, that aim to eliminate the greatest percentage of foci of endometriosis, to assisted (in vitro) fertilization techniques, in which fertilization is done in a controlled environment (laboratory), with very good results. Fortunately all of these techniques, surgical as well as assisted fertilization, are available in Guatemala.

Endometriosis is a disease that affects millions of women worldwide. In many of them the condition goes by undetected, while in others it demands professional attention, especially when fertility is compromised or when pain affects the way of life. It is of special relevance then that women choose a qualified doctor that is familiar with the most recent advances on endometriosis management. The specialist physician, based on the personal situation of each woman, will recommend the course of treatment that is most appropriate.

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Figure 1: PELVIC VIDEO LAPAROSCOPY

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Figure 2: FOCI OF ENDOMETRIOSIS SEEN BY A LAPAROSCOPY