What is endometriosis? Be careful of infertility!

The endometrium is the membrane that makes up the inner wall of the mammalian uterus, and the endometrium changes with the sexual cycle. When the endometrium is diseased, it will have a certain impact on the human body. As for what endometriosis is, it may cause female infertility.

1. Concept

Endometriotic diseases include endometriosis and adenomyosis, both of which are caused by ectopic endometrium with growth function and often coexist clinically. However, the pathogenesis and histogenesis of the two are not exactly the same, and the clinical manifestations and their sensitivity to ovarian hormones are also different. The former is sensitive to progesterone, while the latter is not.

When endometrial tissue (glands and stroma) appears outside the uterine body, it is called endometriosis, or endometriosis for short.

2. Symptoms

(1) Infertility: The infertility rate of patients with endometriosis is as high as 40%. The causes of infertility are complex, such as changes in the pelvic microenvironment affecting the combination and transport of sperm and eggs, abnormal immune function leading to an increase in anti-endometrial antibodies that destroy the normal metabolism and physiological function of the endometrium, and abnormal ovarian function leading to ovulation disorders and poor corpus luteum formation. Moderate to severe patients may have adhesions around the ovaries and fallopian tubes, which may affect the transport of fertilized eggs.

(2) Menstrual abnormalities: 15% to 30% of patients experience increased menstrual flow, prolonged menstruation, or prolonged menstruation or premenstrual spotting. It may be related to ovarian parenchymal lesions, anovulation, corpus luteum insufficiency, or combined with adenomyosis and uterine fibroids.

3. Treatment

Mild lesions with mild or no symptoms can be treated expectantly; mild patients with fertility desires can be given drug treatment first after a comprehensive diagnosis and evaluation, and severe cases can undergo fertility-preserving surgery; young severe patients with no fertility desires can undergo ovarian function-preserving surgery and supplemented with sex hormone therapy; patients with severe symptoms and lesions and no fertility desires should consider radical surgery.