Question

A 32-year-old woman is 5-6 weeks pregnant with her first child. She complains to her obstetrician of pelvic pain and some light vaginal bleeding. The patient has a history of endometriosis, a disorder in which an abnormal growth of tissue, similar to the tissue lining the uterus, grows in a location outside of the uterus.

The patient's endometriosis has pinched off one of her uterine tubes. What will happen if the ovum is not able to pass through the uterine tube?

Answer 1

Endometriosis can lead to infertility if the displaced endometrial tissue causes blockage in the fallopian tubes, preventing sperm from meeting the ovum or hindering the passage of a fertilized egg to the uterus for implantation. Scarring and inflammation are also common side effects that contribute to infertility. Treatment includes medication and surgery to manage symptoms and improve fertility outcomes.

Step-by-step explanation:

Endometriosis and Risks of Infertility

If an ovum is not able to pass through the uterine tube due to blockage from endometriosis or other complications, it could lead to infertility. Endometriosis is a condition where endometrial tissue, which normally lines the inside of the uterus, grows outside of it. This displaced endometrial tissue can cause scarring, inflammation, and adhesions on surrounding pelvic organs. During each menstrual cycle, this tissue acts as it normally would—it thickens, breaks down, and bleeds. However, unlike the lining within the uterus that is expelled during menstruation, the blood from the endometrial tissue outside the uterus has no way to exit the body and becomes trapped. This can cause pelvic pain, especially during menstruation, and can form cysts, scar tissue, and adhesions, potentially leading to complications such as blocked fallopian tubes.

With endometriosis, if the uterine tube is pinched off, it prevents the sperm from reaching the ovum or the fertilized egg from traveling to the uterus for implantation, resulting in infertility. There is also a risk of an ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, typically in a fallopian tube. This is a medical emergency and requires prompt treatment. Treatment options for endometriosis include pain medications, hormonal therapies to reduce or eliminate menstruation, and surgery to remove endometrial growths. It is important for women with endometriosis who are planning pregnancy to discuss their condition with their healthcare provider to determine the best treatment and management plan.