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During the last stage of the menstrual cycle, normally a layer of endometriosis lining on the inside of the uterus is expelled, known as menstruation blood, instead some of the endometriosis tissues grow somewhere in the body to cause endometriosis. Endometriosis also react to hormone signals of the monthly menstrual cycle, by building and breaking up tissues and eliminating them through menstrual period.
Infertility is always difficult for women with endometriosis. In fact depending on the stage of endometroisis and where endometriosis implants in the body, some women may not even get pregnant at all if they are on the last stage of endometroisis and the cysts is located in the fallopian tubes, ovaries, and uterus because of the enlarged endometrosis cysts not only causing inflammation but also interfering with each stage of the menstrual cycle. In general, women with endometriosis find it harder to become pregnant than other women(1)(2).
Some physicians in the infertility field do feel there is an increase in the risk of miscarriage with endometriosis. Some feel there is no increase in the miscarriage rate. One of the studies looked at the miscarriage rates in patients prior to treatment of endometriosis and compared to the miscarriage rates in the same patients after treatment of endometriosis. In these studies patients had lower miscarriage rates after treatment. Women pregnant with endometriosis should be wise to seek help from specialists for treatment that not only nourishes the fetus but also controls the progression of endometriosis(3)(4).
3. Ectopic pregnancy
An ectopic pregnancy is a complication of pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall, caused by blockage of endometroisis of the fallopian tubes leading to an ectopic pregnancy. In fact, the fetus produces enzymes that allow it to implant in varied types of tissues, and thus an embryo implanted elsewhere than the uterus can cause great tissue damage in its efforts to reach a sufficient supply of blood, sometime it is life threatening to the mother(5)(6).
Dyspareunia is painful sexual intercourse. When pain occurs, the woman experiencing it may be distracted from feeling pleasure and excitement. Women with endometriosis suffer from dyspareunia if endometriosis is located in the major ligaments of the uterus. Endometriosis-related dyspareunia is usually positional and most intense upon deep penetration. It is most intense prior to menstruation(7)(8).
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(3) Endometriosis, recurrent miscarriage and implantation failure: is there an immunological link? by Tomassetti C1, Meuleman C, Pexsters A, Mihalyi A, Kyama C, Simsa P, D'Hooghe TM.(PubMed)
(4)Possible role of endometriosis in the aetiology of spontaneous miscarriage in patients with septate uterus.by Gergolet M1, Gianaroli L, Kenda Suster N, Verdenik I, Magli MC, Gordts S.(PubMed)
(5)Ectopic pregnancy after IVF in a patient with unilateral agenesis of the fallopian tube and ovary and with endometriosis: search of the literature for these associations by Vaiarelli A1, Luk J, Patrizio (PubMed)
(6) Tubal ectopic pregnancy: a patho-physiological explanation involving endometriosis by Hunter RH.(PubMed)
(7)Dyspareunia and quality of sex life after surgical excision of endometriosis: a systematic review by Fritzer N1, Tammaa A2, Salzer H2, Hudelist G3.(PubMed)
(8) Endometriosis patients in the postmenopausal period: pre- and postmenopausal factors influencing postmenopausal health by Haas D1, Wurm P2, Schimetta W3, Schabetsberger K4, Shamiyeh A5, Oppelt P1, Binder H6.(PubMed)