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Our Services / Infertility Services

Endometriosis and Infertility

Introduction


Endometriosis is the condition where the lining of the uterus (a.k.a. the endometrium) grows outside the uterus, commonly on the ovaries, outer surface of the uterus, fallopian tubes, and the pelvis. It can also grow on the bowel and bladder. In rare cases it can also spread to distant parts of the body like the lungs, nose, throat and brain. Endometriosis is a major debilitating disease that affectsup to 10% of all women in the reproductive age and up to 60% of women with infertility. Patients with endometriosis usually have pelvic pain, pain with menses, pain with intercourse, or may present with difficulty in conceiving children. It is important to note, some patients have no symptoms other than infertility.Unfortunately, laparoscopy is still the gold standard in diagnosing this disease and currently, the average time between the start of symptoms and the actual diagnosis is 5.5 years. It may start very early in life, at the start of the first menses and continue all the way up to premenopausal years.


Causes


We still do not know the exact cause of endometriosis, but immune disorder is the most likely cause. It runs in families with up to a 70% chance that there is a first degree relative with endometriosis. The backward flow of blood and endometrial tissue into the pelvis during menses is the way the tissue comes into the pelvis and starts the disease.  In women who do not have endometriosis, any blood or endometrial tissue that makes its way into the pelvis is absorbed by the body and does not grow outside the uterus.


Treatment


At the Center for Reproductive Medicine and Robotic Surgery, we have developed the latest advanced technology to treat this disease.



We also conduct cutting edge research in developing new treatment plans including medications for this disease which greatly affect the activities of daily living of many patients. Initially patients undergo an evaluation by assessing the severity of the disease. This is done by assessing the hormones as well as performing an ultrasound scan and /or laparoscopy to confirm the diagnosis. Patients then undergo Robotic Assisted Excision (RAE) of all the endometriotic lesions which will stage the degree of the disease. Please see the videos of how the surgery is done.



After surgery, depending upon the severity of the disease as well as the patient’s desires, the patient undergoes treatment. It may be as simple as observation with an ultrasound scan every 6 months. Treatment could also include hormone therapy, pain control or assisted reproductive treatments. Patients with endometriosis have a very low chance of spontaneous conception of less than 2%. With our unique treatment consisting of robotic assisted resection of the disease followed by IVF treatment and micro manipulation of embryos in our CAP accredited lab, we have been able to successfully increase the chance of conception to 77%.

At The Center for Reproductive Medicine and Robotic Surgery(CRMRS) we provide private, professional and compassionate fertility care. Dr. Jacob and our reproductive team provide a very personalized approach, from diagnostic assessment and early intervention through high-tech procedures like In Vitro Fertilization (IVF), and Intracytoplasmic Sperm Insertion (ICSI), intrauterine insemination (IUI) and Pre-Implantation Genetic Testing – Aneuploidy (PGT-A).

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