During this webinar session, Dr Elias Tsakos, a renowned Fertility Expert and Medical Director of Embryoclinic explained the relationship between adenomyosis, endometriosis, and its impact on recurrent miscarriages.
The word “endometriosis” originates from Greek, with “endo” meaning inside and “mitriosis” referring to the inner lining of the uterus. This descriptive term characterizes the presence of tissue resembling the uterine lining outside its usual location. Endometriosis has a complex nature, profoundly affecting women’s lives, fertility, and medical interventions.
Endometriosis stands as a significant bridge between fertility surgery and fertility medicine. Dr Tsako’s experience, dating back to the 90s, involves training in both fertility medicine and surgery. While this blend has evolved, endometriosis continues to underscore the interplay between these fields.
Endometriosis and its manifestations
Endometriosis involves tissue resembling the uterine lining appearing outside its normal location. It can manifest in various areas, such as ovaries, ligaments, tubes, uterus wall, and even distant locations like the diaphragm or lungs. This condition leads to inflammation and fibrosis, causing symptoms like pain, bloating, painful periods, painful intercourse, and infertility. Sometimes, endometriosis remains silent, with infertility being the primary indicator.
The complexity of endometriosis
Visualizing endometriosis is akin to observing an iceberg: what’s visible is merely a fraction of what lies beneath. Just like a chameleon adapting to its environment, endometriosis symptoms and appearances can change, posing diagnostic challenges. Another analogy is that of a time bomb—endometriosis may remain undetected for years until it presents with severe symptoms or complications.
Endometriosis is like a chameleon, changing its appearance and symptoms; we must be vigilant and adaptable in our approach.
Adenomyosis: The Uterine Wall Counterpart
Adenomyosis, like the “sibling” of endometriosis, involves tissue growing within the uterine wall muscles. This condition can lead to pain, enlarged uterus, and infertility, and often coexists with endometriosis or fibroids.
Impact on Fertility & Treatment Approaches
Both endometriosis and adenomyosis significantly impact fertility. Lowered implantation rates, fewer oocytes retrieved in IVF, increased multiple pregnancies, and elevated miscarriage rates are notable effects. Understanding these impacts is crucial for fertility management.
Treatment strategies include a combination of fertility treatments, medical interventions, and surgery. Diagnosing accurately is paramount, and vigilance is key, particularly for silent endometriosis cases. Surgical options, including minimally invasive and robotic surgery, play a pivotal role in managing these conditions and improving fertility.
A multidisciplinary approach is pivotal for comprehensive care. Collaboration among various specialists, including gynaecologists, radiologists, and psychologists, is essential for optimal diagnosis and treatment. Robotic surgery emerges as a potent tool in managing complex cases.
Endometriosis poses intricate challenges, but with advancing knowledge and technology, we are better equipped to tackle it. Vigilance, accurate diagnosis, and comprehensive care are crucial for helping women navigate the impact of endometriosis on their fertility journey.