Endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, affects 2-10% of women of reproductive age and up to 50% of infertile women. This benign gynecological condition often occurs in the ovaries, fallopian tubes, pelvic peritoneum, and nearby organs. Influenced by menstrual cycle hormones, these lesions can cause inflammation, localized bleeding, scar tissue formation, and adhesions.

The disease has a complex formation mechanism and is influenced by menstrual cycle hormones, meaning it can recur. The risk of recurrence depends on the severity of the disease, the location of the lesions, the surgical technique used, and whether the patient uses maintenance medication after surgery.

Master of Science, Doctor Tran Ngoc Ha Giang performs an ultrasound for a patient. *Illustration: IVF Tam Anh*

For women under 35 years old, trying to conceive for 12 months is the standard for diagnosing infertility. Delayed pregnancy could be due to recurrent endometriosis, but other contributing factors from either partner should also be considered.

Endometriosis impacts conception through multiple mechanisms. Chronic inflammation and pelvic scar tissue or adhesions can deform or block fallopian tubes, hindering the meeting of egg and sperm. Previous cyst removal or recurrent cysts on the ovaries also risk reducing egg quantity and quality (ovarian reserve). Furthermore, the inflammatory environment in the pelvis can lower fertilization and embryo implantation rates.

The couple should visit a specialized reproductive health facility for a comprehensive examination as soon as possible. Doctors will perform an ultrasound to check the uterus and ovaries, test ovarian reserve (AMH), assess fallopian tube patency, and conduct a semen analysis for the husband. If endometriosis recurs, doctors will advise on appropriate treatment based on the condition and the patient's wishes.

At the Center for Reproductive Support, Tam Anh General Hospital, infertile patients with endometriosis receive individualized treatment protocols. These protocols are developed based on disease severity, age, ovarian reserve, and issues related to the uterus, fallopian tubes, and male factors. Depending on the case, doctors advise suitable treatment plans aimed at controlling lesions, preserving ovarian reserve, and optimizing pregnancy chances.

Master of Science, Doctor Tran Ngoc Ha Giang

Center for Reproductive Support

Tam Anh General Hospital, Ho Chi Minh City