Endometriosis and Infertility

Our providers have spent many years researching and treating women in Hawaii and elsewhere for endometriosis and endometriosis-related infertility. Dr. Frattarelli and Dr. Karmon have given several invited lectures detailing the current research and treatment options for endometriosis. The infertility clinic in Hawaii is equipped to evaluate and offer all treatment options to patients with endometriosis.

Endometriosis is a condition in which endometrial tissue (tissue that lines the inside of the uterus) grows outside the uterus.

Endometriosis may be a cause of infertility. Endometrial tissue grows outside the uterus and attaches to other organs in your abdominal cavity such as the ovaries and fallopian tubes. The endometrial tissue inside and outside of your uterus responds to your menstrual cycle hormones in a similar way – it swells and thickens, then sheds to mark the beginning of the next cycle. Unlike the menstrual blood from your uterus that is discharged through your vagina, the blood from the endometrial tissue in your abdominal cavity has no place to go. Inflammation occurs in the areas where the blood pools, forming scar tissue.

Scar tissue can block the fallopian tubes or interfere with ovulation. In addition, endometrial tissue growing inside the ovaries may form a type of ovarian cyst called an “endometrioma”, which may interfere with ovulation. Endometriosis is a progressive disease. It tends to get worse over time and can reoccur after treatment. Endometriosis usually improves after menopause.

How endometriosis is diagnosed

Your medical history and a pelvic exam may suggest the diagnosis of endometriosis. However, only a laparoscopy can confirm this diagnosis. A laparoscopy is an outpatient surgical procedure. Your doctor may use a narrow fiberoptic telescope inserted through an incision near your navel to look for and sometimes remove scar tissue and endometrial tissue attached to other organs.

Medications are mainly used to treat infertility associated with endometriosis. If, however, there is severe disease, than In Vitro Fertilization may be recommended. Surgery and medication treatment can be used for pain associated with endometriosis.