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More than 13 million women in the United States are known to suffer from endometriosis, a disease for which we provide diagnosis and treatment at our Chicago-area fertility centers. The disease is characterized by the growth of the uterine lining (endometrium) outside of the uterus. The uterine endometrium during the first half of the menstrual cycle increases in thickness and, during the second half, acquires a spongy-like consistency to facilitate embryo implantation. If there is no pregnancy, the uterine endometrium sheds, along with the menstrual blood, during the menstrual period. With endometriosis, the same cyclic changes that would typically only occur within the uterus now also occur outside the uterus. As the endometrial tissue has grown outside of the uterus, elements of the cycle follow the tissue. This causes bleeding into the abdomen or other organs, inflammatory reaction, development of adhesions (scar tissue), or the appearance of cysts filled with blood which, over time, acquire a consistency of liquid chocolate (chocolate cysts).
The cyclic changes associated with endometriosis described above are responsible for symptoms of the disease that include:
The frequency and intensity of these symptoms vary, and there is no direct relationship between the symptoms and the severity of endometriosis. Some women with advanced endometriosis have few, if any, symptoms; others have severe symptoms with only minor endometriosis. The intensity of symptoms is most likely related to the local inflammatory reaction and production of substances, such as prostaglandins and cytokines, by the endometriotic cells and cells of the immune system.
Based on characteristic symptoms, physical examination findings, and/or changes on pelvic ultrasound, CT scans, or x-rays, endometriosis may be suspected at one of Chicago-area fertility centers. However, other diseases may present similar findings, and the only way to diagnose endometriosis is through a surgical procedure called a laparoscopy or laparotomy. The diagnosis needs to be confirmed by microscopic examination of the tissue. Not every lesion having a visual appearance of endometriosis is actually endometriotic and sometimes atypical lesions may be endometriotic in nature. Your laparoscopic surgeon will take a biopsy to confirm through visual diagnosis. Your physician will also likely assign a score for the size, depth, and location of endometriotic lesions. This is the basis for classifying endometriosis as Stage I, II, III, or IV - with Stage I being minimal and Stage IV being the most advanced. Endometriosis is a progressive disease which impairs fertility, tends to recur after treatments, and lasts as long as there is ovarian function. After menopause, endometriosis will subside. Prompt, definitive endometriosis diagnosis and staging at our Chicago, Illinois fertility centers are extremely important for lifelong treatment, recurrence prevention, and family planning.
Laparoscopy is a minor surgical procedure performed under anesthesia on an outpatient basis. An experienced laparoscopic surgeon should be able to resect or destroy endometriotic lesions with the use of electrical current or laser at the time of laparoscopy. Alternative treatments include various types of hormonal medications, the purpose of which is to suppress ovarian function and stop menstrual cycles. Without menstrual bleeding, endometriotic lesions heal and gradually disappear. Large chocolate cysts and adhesions may need to be removed surgically.
The choice of endometriosis treatment at our Chicago-area fertility centers depends on several factors, including:
These factors and patient-specific indications and contraindications, advantages and disadvantages, and risks and benefits of different treatment options need to be thoroughly discussed and considered prior to endometriosis treatment selection. At Reproductive Medicine Institute, we will work to ensure that you have a true understanding of the disease and all of your available treatment options before any decisions are made.
At the Reproductive Medicine Institute, our objective is to help you select the treatment option that is most appropriate for you. Our overall goal is to remove or suppress endometriosis, to delay its recurrence, to control its progression, and to address its symptoms — all without adversely affecting your fertility or exposing you to undesirable side effects of treatments. We recognize that different women may respond differently to the same treatment, both in terms of the effectiveness and side effects. Indeed, there is no one treatment that would be effective in all women.
At the Reproductive Medicine Institute, we always have several ongoing clinical research projects. We also frequently have new medications for clinical trials before they become generally available. Such clinical studies, including medications, may be provided at no charge to you.
For more information, please contact us today to schedule a personal consultation to discuss endometriosis at one of fertility centers in the Chicago area.