How Can Endometriosis Cause Infertility?

Endometriosis is a benign gynecological disease in which endometrial tissue with growth function appears in parts other than the coated mucosa of the uterine cavity. The infertility rate of normal women is about 15%, and that of patients with endometriosis can be as high as 40%. Why can endometriosis cause infertility?rnAt present, the mechanism of infertility caused by endometriosis is not clear. Most studies have confirmed that endometriosis can cause adhesion between reproductive organs such as the uterus, fallopian tube and ovary, and surrounding tissues, resulting in the abnormal discharge of follicles, failure of sperm to reach the ampulla of the fallopian tube, and failure of fertilized eggs to reach the uterus, which will affect pregnancy. Endometriosis can lead to changes in pelvic fluid, which affects the combination of sperm and eggs. The endometrium grows into the myometrium of the uterus, forming adenomyosis. Affected by endometriosis, the elasticity of the uterus is weakened, and the shape is changed. It has a certain negative impact on the receptivity of the endometrium. In addition, endocrine disorders, uterine dysfunction caused by endometriosis, and embryo implantation are also closely related to infertility. Now it is generally believed that infertility in patients with endometriosis may also be related to the following factors: 1. Insufficient luteal function: the number of LH receptors on follicles and luteal cells in patients with endometriosis is less than that in normal women, resulting in insufficient luteal secretion in the luteal phase and affecting pregnancy. 2. Luteinized unruptured follicle syndrome is ovarian anovulation, but follicular cells are luteinized. Although the patient's body temperature is biphasic and the endometrium shows a secretory phase, there is no possibility of pregnancy. The diagnosis is based on the fact that there is no ovulation hole on the ovarian surface 4 ~ 10 days after the due ovulation period under laparoscopy. Two days after the LH peak, the follicles continued to grow at the time of examination. During the menstrual cycle, the amount of peritoneal fluid, especially estrogen and progesterone in peritoneal fluid, has "no sudden increase." It has been reported that the incidence of LUFS in patients with endometriosis is significantly higher than that in normal women, complicated with infertility. Some experts suggest that due to the existence of LUFS, the levels of estrogen and progesterone in the peritoneal fluid are low, which does not inhibit the implantation of endometrial cells flowing back to the abdominal cavity in pelvic endometriosis. Therefore, it is considered that LUFS is the cause of membrane ectopia. However, this theory has not been recognized by people. 3. Autoimmune reaction: the anti-endometrial antibody produced by B lymphocytes in patients with endometriosis can interfere with the delivery and implantation of early fertilized eggs. The increase of macrophages in the abdominal cavity can also phagocytize sperm and interfere with the division of egg cells, resulting in infertility. Can infertility caused by endometriosis be treated? The mechanism of infertility caused by endometriosis is complex, involving changes in pelvic anatomical structure, the decline of endometrial receptivity, the decline of ovarian function, the change of intraperitoneal environment, and fertilization disorder, etc. Therefore, it is difficult to have a single answer to the treatment plan for such patients, and the appropriate treatment method needs to be selected according to patients' specific situations. There are two main methods for treating endometriosis: conservative drug treatment and surgical eradication of lesions. 1. Medication The drugs for treating endometriosis mainly include gonadotropin-releasing hormone agonists, oral contraceptives, progesterone, etc. Drugs can effectively treat endometriosis-related pain and reduce postoperative recurrence, but there is no evidence for increasing pregnancy rates and improving infertility symptoms. Because long-term use of hormone drugs may cause harm to the body, more and more patients prefer herbal medicine therapy, such as Fuyan Pill. It can eliminate the symptoms of endometriosis without side effects. And it can clean up toxins in the uterus and improve the chance of natural pregnancy. 2. Surgical treatment A subtotal hysterectomy can be performed for patients with large lesions affecting their normal life or without fertility requirements. For patients with severe conditions and fertility requirements, local endometrial surgery can be selected.