Endometriosis and Infertility

Endometriozis-And-Infertility

Understanding Endometriosis

Endometriosis occurs when endometrial-like tissue grows outside the uterus, causing inflammation, scar tissue, and hormonal disruption.
It affects 1 in 10 women and is a major — often underestimated — cause of infertility.

At Saga Clinic Tirana, Dr. Eser Agar provides precise diagnosis and individualized fertility planning for women with endometriosis, whether they are trying naturally or preparing for assisted reproductive treatments.

How Endometriosis Affects Fertility

Endometriosis can interfere with fertility in several ways:

1. Inflammation Around the Ovaries and Tubes

Inflammation affects egg quality, ovulation, and embryo development.

2. Pelvic Adhesions

Scar tissue can:

  • Distort pelvic anatomy
  • Restrict egg release
  • Block fallopian tubes
  • Prevent sperm from reaching the egg

3. Endometriomas (Ovarian Cysts)

Endometriomas can reduce ovarian reserve and affect response to fertility treatment.

4. Hormonal Imbalance

Endometriosis can disrupt progesterone response and impair implantation.

5. Immune System Changes

The uterus may become less receptive to embryo implantation.

Even mild or moderate disease can reduce natural fertility.

Symptoms Suggesting Endometriosis

Not all women have symptoms, but common signs include:

  • Painful periods
  • Pain during intercourse
  • Chronic pelvic pain
  • Painful bowel movements
  • Heavy menstruation
  • Infertility or difficulty conceiving

Silent endometriosis is also common and discovered only during fertility evaluation.

Diagnosing Endometriosis at Saga Clinic

1. Detailed History & Symptom Review

Pain characteristics, menstrual cycle patterns, previous surgeries, and infertility duration are evaluated.

2. Transvaginal Ultrasound

Used to detect:

  • Endometriomas
  • Ovarian cysts
  • Deep infiltrating nodules (in some cases)
  • Structural abnormalities

3. Hormonal and Fertility Testing

  • Ovarian reserve (AMH, AFC)
  • Ovulation assessment
  • Tubal patency (HSG)

4. Diagnostic Laparoscopy (If Needed)

The gold standard for diagnosis.
Performed when symptoms are severe or when ultrasound is inconclusive.

Treatment Approach for Endometriosis-Related Infertility

Treatment depends on:

  • Age
  • Ovarian reserve
  • Stage of endometriosis
  • Presence of endometriomas
  • Duration of infertility
  • Previous treatments
  • Symptoms such as pain

1. Medical Management

Pain and inflammation can be reduced, but medical therapy alone does not improve fertility.
It is used to prepare the body before fertility treatment or to control symptoms.

2. Surgical Treatment

Laparoscopic surgery may be recommended for:

  • Large endometriomas
  • Severe pelvic adhesions
  • Tubal distortion
  • Deep infiltrating disease

Surgery can improve pain and sometimes natural fertility, but it must be balanced carefully against the risk of reducing ovarian reserve.

3. Natural Conception Strategies

For mild cases in younger women, ovulation monitoring and timed intercourse may be effective.

4. Ovulation Induction + IUI

Suitable for:

  • Mild to moderate endometriosis
  • Open tubes
  • Normal semen parameters

Success rates are lower than unexplained infertility but can still be beneficial in selected couples.

5. IVF Treatment

IVF is often the most effective option for women with endometriosis, especially when:

  • Tubes are blocked
  • Endometriomas are present
  • Ovarian reserve is compromised
  • Multiple infertility factors coexist
  • Age is 35+
  • IUI cycles have failed

IVF bypasses tubal problems and helps overcome inflammatory effects.

Does Endometriosis Lower IVF Success?

Endometriosis can slightly affect egg number and sometimes embryo development.
However, with modern protocols:

  • Good-quality embryos can be achieved
  • Implantation rates remain high
  • PGT may be beneficial in selective cases
  • Frozen embryo transfer cycles can improve success

At Saga Clinic, IVF strategies are personalized to maximize outcomes for each patient.

Why Choose Saga Clinic for Endometriosis and Infertility Care?

  • Expertise in diagnosing complex endometriosis
  • Careful preservation of ovarian reserve
  • Advanced fertility planning
  • Evidence-based IVF protocols
  • High-quality ultrasound imaging
  • Personalized treatment for both pain and fertility
  • Direct care by Dr. Eser Agar throughout the process

We aim to create a safe, clear, and effective path to pregnancy for women with endometriosis.

Appointments and Contact

If you suspect endometriosis or have difficulty conceiving, early evaluation is essential.
Contact Saga Clinic Tirana for a detailed consultation.

Contact & Appointments

For appointment requests or medical inquiries, please contact us using the options below.

📞 Clinic Phone (Office Hours)
+355 69 836 1565
Available Monday–Saturday, 09:00–16:00.

💬 WhatsApp (Outside Office Hours)
+355 69 362 0838
Available outside office hours via WhatsApp Message only.