Endometriosis

Endometriosis, one cause of female infertility, is a condition caused when endometrial tissue, which is the tissue that lines the inside of the uterus, begins to grow outside of the uterus and attaches to other organs (such as the fallopian tubes or ovaries) within the abdominal cavity.  A progressive disease, endometriosis has a tendency to grow worse over time.  It can also reoccur after treatment.  

During your menstrual cycle the endometrial tissue outside your uterus responds in the same way as the tissue inside.  It thickens and swells, then sheds to initiate the beginning of the next cycle.  Because the blood shed from endometrial tissue in the abdominal cavity has no way to be eliminated, it pools and causes inflammation that causes pain and forms scar tissue.  This scar tissue can both interfere with ovulation and block the fallopian tubes.  Another result that can affect ovulation is when the endometriosis grows into the ovaries, forming cysts called endometriomas.

In the drawing above, pieces of endometrial tissue (implants) are identified by blue dots.  Common sites of endometrial implants include:

• Outer surface of the uterus
• Fallopian tubes
• Ovaries
• Bowel
• Space between rectum and vagina