Overview Causes Symptoms Treatment
What is Endometriosis-related infertility?
Endometriosis-related infertility refers to difficulty conceiving that occurs when endometriosis, a condition in which tissue similar to the uterine lining (endometrium) grows outside the uterus, interferes with reproductive function.
Common Related Conditions
Causes of Endometriosis-related infertility
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, and pelvic peritoneum. This ectopic tissue can cause inflammation, scarring, and adhesions, which may distort pelvic anatomy and interfere with ovulation, fertilization, or implantation. Other contributing factors include ovarian cysts (endometriomas), hormonal imbalances, immune system dysfunction, and chronic pelvic inflammation. In some cases, even mild endometriosis can affect egg quality or embryo implantation through biochemical changes in the pelvic environment.
How does endometriosis affect fertility?
30-40% of women with endometriosis who are trying to conceive are diagnosed with infertility. Endometrial implants are often found surrounded by tiny but powerful strands of collagen, the building blocks of adhesions. Because endometrial implants swell each month with a woman’s periods, we find the pull on the adhesions as the cause of so much pain in our clients. With our published success and focus on decreasing or eliminating adhesions, the Clear Passage® approach has been used by many women as an alternative to surgery for the pain and infertility associated with endometriosis.
Adhesions act like glue, binding reproductive structures in curtains or rope-like bonds of collagen fibers, sometimes attaching them to neighboring structures. Bound as they are in adhesive straitjackets, the reproductive organs cannot move or function normally.
Endometrial adhesions may attach to one or both ovaries, causing ovulation pain or creating an outer covering, decreasing their ability to release an egg. Adhesions can block fallopian tubes in two ways – squeezing them closed from the outside or (more commonly) blocking them from the inside.
We find that endometriosis located on or near the uterus can cause uterine spasm or painful periods, decreasing the opportunity for implantation, or causing miscarriage. Endometriosis, which attaches to the nearby bowels, may cause painful bowel movements, back, tailbone, or intestinal pain. In short, endometrial adhesions within the reproductive tract can cause pain or dysfunction anywhere in the back or pelvis, including intercourse pain and infertility.
Symptoms of Endometriosis-related infertility
- Difficulty conceiving despite regular intercourse
- Painful periods (dysmenorrhea)
- Chronic pelvic or lower abdominal pain
- Pain during intercourse (dyspareunia)
- Painful bowel movements or urination during menstruation
- Heavy menstrual bleeding (menorrhagia) or irregular cycles
- Fatigue or low energy
- Pelvic tenderness or swelling
- Sometimes, endometriosis may be asymptomatic, with infertility being the first noticeable issue
- Pain after endometriosis surgery
Treatment for Endometriosis-related infertility
Being invisible to all diagnostic tests, adhesions have stymied Western physicians for decades. At a cellular level, they are composed of tiny but powerful collagen fibers, similar to the strands of a nylon rope. These fibers lie down on each other in a random pattern, forming a blanket or scar to surround endometrial implants and nearby tissues. Adhesions have recently been measured with a tensile strength of 15,000 pounds per square inch. Once formed, they can act like powerful glue or straitjackets in the body, causing pain or dysfunction as they bind delicate structures that should be free and mobile to work properly.
Standard diagnosis is based on symptoms but typically requires exploratory surgery. Surgical treatment generally involves cutting or burning the endometrial implants and surrounding adhesions, but many women report new or returning pain in the months following surgery, for good reason. The Journal of Laparoscopic Surgery notes that the least invasive of all internal surgeries causes new adhesions to form in 97% of cases – at the exact site where surgery removed adhesions. Clearly, the finest doctors cannot prevent new adhesions from forming after the surgery designed to remove them.
We came to realize that we could detach these powerful strands from each other without surgery by focusing on the molecular-chemical bonds (called cross-links) that attach each collagenous strand to the next. As we developed our unique therapy, adhesions seemed to dissipate while pain and infertility often resolved quickly. To our therapists, it felt as if we were pulling out the run in a three-dimensional sweater, using just our hands.
The “hands-on” work practiced at Clear Passage® clinics is designed to reduce or eliminate adhesions, cross-link by cross-link. It has been shown to work extremely well for women with endometriosis and to have lasting effects. Many women who arrive with a history of endometriosis and infertility are now mothers of one or more children after a single five-day therapy session at Clear Passage®.
Other Treatment Options (Surgery, Drugs)
Pharmaceutical treatments for endometriosis pain generally involve hormones that prevent endometrial swelling, but also prevent pregnancy. Many women with endometriosis infertility are encouraged to undergo laparoscopic surgery to burn or cut out endometriosis and any accompanying adhesions. We suggest checking your physician’s philosophy before undergoing surgery. Some are conservative; others are more aggressive.
No matter how wonderful and skilled the physician is, every surgery carries some risks, including:
- Post-surgical adhesions. In an early mammoth 58-year study of medical literature, researchers found that adhesions occur in 55-100% of women undergoing pelvic surgery.
- The least invasive surgery, laparoscopy, causes new adhesions to form in 97% of cases.
- Risks associated with general anesthesia and infection.
- Inadvertent enterotomy (mistakenly cutting the bowel, bladder, rectum, a fallopian tube, or other structures).
Unfortunately, post-surgical adhesions can cause recurrence of pain or infertility; endometriosis tends to re-grow and spread at and around surgical sites after surgery. A study published in Fertility and Sterility found that endometriosis was most likely to re-grow in the places where it was removed during laparoscopic surgery and that unaffected regions next to endometriosis were more likely to develop endometriosis after laparoscopic surgery.
Pregnancy rates after laparoscopic surgery vary depending on the severity of the endometriosis. Women with stage I-II endometriosis experience far greater success than women with stage IV. This is because women with stage III-IV frequently have deep endometrial implants that a surgeon cannot remove without damaging the organ or tissue. In published research, Clear Passage® pregnancy rates were shown to be 43% in women with endometriosis, in a group that included women with total tubal blockage. These rates are equivalent to or better than either IVF or surgical pregnancy rates, without the risks or side effects of post-surgical adhesions, at a fraction of the cost.
Condition Specific Disclaimer:
Clear Passage® Therapy is a non-surgical, manual physical therapy designed to address adhesions and restricted soft tissue mobility. While some patients report improvement in pelvic mobility, reduction of adhesions, and enhanced reproductive function, results vary by individual.
The information provided on this website is for educational purposes only and is not intended as medical advice. Clear Passage® Therapy does not diagnose endometriosis, infertility, or any strictly medical condition. The information here should not replace evaluation by a licensed physician or fertility specialist. We encourage all patients to seek consultation with a qualified physician.
Testimonials:
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