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Doctor K: Endometriosis may affect your fertility

DEAR DOCTOR K: I have endometriosis. Could this affect my fertility?

DEAR READER: Endometriosis can affect fertility – but not in every case.

Endometrial tissue is the inner lining of the uterus. Normally, that’s the only place in the body where it grows.

However, with endometriosis, the same type of tissue also grows where it shouldn’t – in places outside the uterus. It may grow in or on the ovaries or fallopian tubes, or in the pelvis or lower abdomen. Endometriosis doesn’t always cause symptoms. But when it does, it can result in severe pain and discomfort.

Whether or not endometriosis affects your fertility depends on its severity and location. It’s more likely to interfere with your fertility if endometrial tissue covers or grows into your ovaries, or if it blocks your fallopian tubes.

There are many available treatment options. Even without treatment, most women with mild endometriosis eventually can become pregnant.

For mild pelvic or abdominal pain, you can try a nonprescription pain medication – ibuprofen (Advil, Motrin), for example, or naproxen (Aleve).

Other treatments relieve pain by controlling levels of female hormones that encourage inflammation within patches of endometriosis.

Surgery is another option if medicines fail. Some procedures may be done laparoscopically, through small incisions. Using specialized surgical instruments, the doctor destroys small areas of extra endometrial tissue growing outside the uterus. Many women who have laparoscopic surgery to improve their fertility become pregnant.

For more extensive endometriosis, you may need traditional abdominal surgery. This is done through a larger incision.

A last-resort treatment is a hysterectomy. This involves removing your uterus, ovaries and fallopian tubes – and any endometrial tissue that comes with them. It is performed only in women with severe disabling pain who no longer want to become pregnant.