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Unexplained Infertility: Could It Be Endometriosis?

Unexplained Infertility: Could It Be Endometriosis?

Women we speak to who have been diagnosed with unexplained infertility are understandably confused and frustrated. Yet, new information has to come to light that suggests many of these cases can in fact be explained.

With endometriosis taking an average of 10 years to diagnose, experts in the field now share that many cases of unexplained infertility may actually be caused by endometriosis, which has been misdiagnosed or missed.

In a study of Turkish women, a laparoscopic procedure showed 15% of women with unexplained infertility had endometriosis. Another 20% had pelvic adhesions or scar tissue, which affects fertility and can result from endometriosis (as well as other fertility health issues or procedures). A French study reveals similar results: Laparoscopic procedures showed endometriosis in 72 out of 114 women diagnosed with unexplained infertility.

How Prevalent is Endometriosis?

Endometriosis affects 5-10% of all women worldwide. It’s estimated that around 30-40% of infertile women have endometriosis.

Signs of endometriosis to watch for: If you have many of these symptoms along with unexplained infertility, further testing may be recommended along with natural therapies to address the imbalance.

  • Fertility problems
  • Pain during the cycle (Dysmenorrhea)
  • Pain during intercourse (Dyspareunia)
  • Pain with bowel movements or urination
  • Abnormal bleeding, heavy bleeding or large clots during the menstrual cycle
  • IBS like symptoms: bloating, diarrhea, constipation, cramping, rectal bleeding
  • Back pain, lower abdominal and pelvic pain
  • Weakness, nausea and fatigue

Testing and Diagnosis Challenges: Transvaginal ultrasound does not usually find endometriosis. Diagnosis often comes from a laparoscopic procedure, which uses a narrow scope to view inside the abdominal cavity. In addition, more doctors are open to diagnosing and treating endometriosis based on a women’s health history, physical symptoms like pain or infertility, and through less invasive examinations.

Do You Suspect Your Fertility Concern Is Caused By Endometriosis?

Endometriosis affects huge numbers of women today. Yet, not all women with endometriosis have fertility problems. If you suspect endometriosis is the reason why you’re having trouble conceiving, have a discussion with your healthcare provider about your symptoms, history and whether further testing might be helpful.

Endometriosis affects women in very different ways. Some women experience tremendous pain even with mild endometriosis. Others don’t know they have it until a laparoscopic procedure or fertility problem reveals it. We are only beginning to learn about how mild endometriosis can affect fertility and reproductive health.

Moderate to severe endometriosis is a clear fertility risk factor. It creates reproductive blockages like scar tissue, adhesions, and can damage the fallopian tubes and ovaries. Endometriomas (chocolate cysts on the ovaries) may actually adhere to the uterus, bowel or pelvic wall, distorting reproductive anatomy. Over time, endometriosis can reduce egg quality and quantity; it also may decrease the success rate of an IVF treatment.

Therapy Options- Medical and Natural

  • Hormone blocking drug treatments like Lupron are helpful to reduce symptoms for some women, but their results are temporary. The disease often re-emerges when the drugs are discontinued.
  • Excision surgery. A qualified surgeon experienced with endometriosis may be able to perform fertility-sparing surgery to remove endometriosis that’s present in the pelvic cavity or elsewhere in the body. This is often a good option, especially if it’s followed up with natural therapies that help to rebalance the body and eliminate triggers from diet and lifestyle.
  • Therapies like Systemic Enzymes and DIM can be paramount to endometriosis recovery, especially when followed along with a nutrient dense Fertility Diet. Learn more here: 5 Steps to Reversing Endometriosis Infertility. Many women find switching to a high fiber, plant-based, organic diet reduces symptoms and improves their fertility health.

If you’re affected by unexplained infertility, make sure your fertility doctor has not missed possible endometriosis. Correcting a misdiagnosis could be the key to solving your problem and experiencing a return to fertility.

For a complete natural program for fertility concerns caused by endometriosis or unexplained infertility, a Fertility Consultation with a fertility herbalist can help guide your way, and create a lifestyle program that best fits your needs and situation.


Dr. Christine Traxler M.D., OB/GYN
Dr. Christine Traxler M.D., OB/GYN

Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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