Symptoms of endometriosis include period pain, heavy periods, and pain or discomfort when going to the toilet or during sexual intercourse. Some females get some or all of these symptoms, others don’t have any symptoms at all.

If you have endometriosis it is often possible to still get pregnant naturally. Sometimes you will have to have fertility treatment such as surgery to excise or destroy the deposits, instillation of oil-based contrast to the uterus, in vitro fertilisation, or other treatments.

There are different types of severity of Endometriosis and it is important to understand what kind of endometriosis is severe. Generally “chocolate cysts” on the ovary or ovaries, called endometriomas are associated with severe disease. Mild deposits, often called peritioneal deposits, maybe mild in their significance and are often detected at laparoscopy in women aged over 30years.

The connection between endometriosis and infertility is difficult to predict for an individual woman. In general, ovarian endometriosis or distortion of the tubes are markers of severe. Pain is not always due to the endometriosis and is not necessarily a marker of severe disease but it can be.

One of the mechanisms of association of endometriosis and infertility is via concurrent adenomyosis. Adenomyosis is a condition in which the lining of the womb grows into the muscle of the wall of the uterus. It worsens with age and is associated with heavy periods, implantation failure and miscarriage. It is complex to treat. Adenomyosis can be recognised on ultrasound scan and MRI of the uterus.

If you think you have endometriosis, speak to your doctor and ask to be referred to a Care Fertility doctor.