Three people sitting with their heads near each other and all looking in the same direction. The middle person holds costume heart shaped glasses in front of their eyes.

Endometriosis and Fertility – How Egg Freezing Can Help

Diagnosis & Treatment March 2, 2022

Endometriosis is a painful condition that affects over 20% of all reproductive-aged patients. It can impact fertility by causing scarring and cysts, which can affect egg quality and damage the fallopian tubes. The effects of endometriosis can worsen over the reproductive years.

Unfortunately, surgery designed to treat the pain and scarring of endometriosis can also affect fertility by damaging the tubes and ovarian tissue.

If you have endometriosis, egg freezing before treatment can be considered to preserve fertility before the disease progresses, egg quality is impacted or before extensive surgery. Speak to one of our EVOLVE experts today to see if egg freezing is right for you. 

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus starts growing in areas in the pelvis causing pain, scarring or cysts. 

This tissue will thicken, break down, and bleed just like your womb lining does each month. However, unlike the womb lining, the misplaced tissue has no way to leave the body during a period. When this tissue breaks down, it collects inside the body, causing irritation and inflammation. This leads to very painful periods and can also affect your fertility.

Inflammation makes scar tissue (called adhesions) develop in the pelvis. When these adhesions happen in the fallopian tubes, it can make the sides of the tubes stick together, resulting in a blockage. Blocked fallopian tubes stop an egg and sperm from meeting, making fertilization impossible. Even if you don’t have blocked fallopian tubes, endometriosis can also lower the likelihood of pregnancy by reducing your egg quality. It’s also important to note that even mild endometriosis which doesn’t block the tubes or cause cysts can affect egg quality. 

Do I Have Endometriosis?

Those who suffer from endometriosis may not even know that they have it. Check out some common endometriosis symptoms below to see if you may be at risk:

  • Very painful periods that interfere with your life 
  • Pain in your lower back or stomach
  • Pain during or after sex
  • Pain going to the bathroom while on your period
  • Feeling nauseous, being constipated, or having diarrhea while on your period
  • Finding it difficult to get pregnant

If you’re worried that you might have endometriosis, speak to your healthcare provider. They will review your medical history and refer you for further testing if necessary.

How is Endometriosis Diagnosed?

To be diagnosed with endometriosis, you may have to undergo a small surgery called a laparoscopy to look for uterine tissue outside of the womb. Your physician may also consider an MRI to diagnose any endometriotic lesions.

How is Endometriosis Treated?

Some patients manage their condition by taking pain medication each month when their symptoms flare up. Others find their symptoms ease by taking contraceptive medicine (this isn’t an option if/when you are trying to conceive). If your endometriosis is severe, surgery to remove the affected tissue may be recommended. 

How Does Endometriosis Impact Egg Quality?

Experts are still trying to pinpoint exactly how endometriosis affects egg quality, but here are the top theories:

  • Endometriomas (Chocolate Cysts): Endometriomas are cysts in the ovaries that have old menstrual blood and endometrial tissue trapped inside. Some, but not all, people with endometriosis will have endometriomas. These cysts are thought to interfere with the production of progesterone and estrogen by the ovaries. These hormones are key for egg development, and endometriomas may stop the eggs from maturing properly. Those with endometriomas also tend to have a reduced egg reserve in the affected ovaries.
  • Inflammation: When endometriosis breaks down each month, the resulting tissue can’t leave the body. This causes inflammatory substances, like macrophages and cytokines, to exist near the ovaries. These inflammatory substances are thought to be toxic to eggs and reduce their quality.
  • Lower Blood Flow: The inflammation caused by endometriosis often leads to the buildup of scar tissue in the reproductive tract. Scar tissue can stop blood from being able to reach the ovaries — meaning they don’t get enough oxygen. Reduced oxygen levels may stop eggs from maturing as they should and consequently lower their quality.

Can Surgery for Endometriosis Damage My Eggs?

Some people undergo surgery to remove the affected tissue. This can ease symptoms and restore their fertility. However, surgery is not risk-free and can affect the chances of getting pregnant. Sometimes, surgery can affect the blood supply to the ovaries and therefore have a negative effect on egg quality. 

Is Egg Freezing Right for Me?

Egg Freezing is a technique where a person’s eggs are extracted and cryopreserved (frozen) for later use. A frozen egg can be thawed, combined with sperm and implanted in the uterus (aka, in vitro fertilization) at a later date. There’s no limit on how long eggs can stay frozen, and their quality won’t decrease as time passes.

Because endometriosis can damage egg quality over time, egg freezing allows patients with this condition to preserve their fertility. This technique may be especially useful if you don’t want to start a family yet. It’s also a good idea to freeze your eggs before having surgery for endometriosis, as there’s a risk the surgery could damage your ovaries or reduce your ovarian reserves 

Do you have endometriosis and are wondering if egg freezing is right for you? Speak to one of our EVOLVE nurses to learn more.

More Articles