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Endometriosis is a condition in which the tissue known as endometrium, which lines the internal region of the uterus, is located outside the uterus. Endometriosis is the underlying cause of the disease, which is commonly referred to as a chocolate cyst in the public. It is common in approximately 5% of reproductive-age women. It could be one of the causes of infertility, with a prevalence of 35-40%. Endometriosis is commonly found in the ovaries, fallopian tubes, and on the uterine surface. It may be seen in other parts of the body on rare occasions. Internal uterine tissue changes throughout the menstrual cycle as a result of the effects of estrogen and progesterone hormones (period cycle). Endometrium, which grows and develops as a result of estrogen hormone action, begins to shed in the second half of the menstrual cycle as estrogen and progesterone hormone levels fall. When menstrual bleeding (period) begins, shed endometrial tissue is discharged. Endometriosis disease is characterized by changes in endometrial tissues that settle outside the uterus and cause bleeding; because this blood cannot be discharged most of the time, it accumulates and damages the surrounding tissues and organs.

What Causes Endometriosis?

Previous research has shown that endometriosis is caused by a genetic or familial factor. The incidence of endometriosis is seven times higher in women whose mother or sister has the disease. Although the exact cause is unknown, the disorder, which prevents the immune system from identifying and eliminating these tissues, is thought to occur as a result of a genetic transition. When a patient’s family members have endometriosis, the disease tends to spread and progress more rapidly.

What are the Symptoms of Endometriosis?

Endometriosis clinical findings vary greatly from patient to patient and may not be proportional to disease prevalence. As endometriosis progresses, female reproductive health suffers and the incidence of infertility rises. Clinical findings are determined by the anatomical location of the disease. Endometriosis is most commonly found in the ovaries, peritoneums surrounding the reproductive organs, the space behind the uterus, uterine bonds, and the uterine back surface. The most common symptom is pain during the menstrual cycle or during sexual intercourse. Endometriosis disease is also associated with abnormal bleeding, spotting, and infertility.

What Is a Chocolate Cyst and Why Does It Occur?

Endometriosis wounds cause bleeding on the ovaries, which spreads in the ovary tissue as the disease progresses. The cysts, which are filled with coagulated dark-colored blood, form. These are referred to as chocolate cysts or endometrioma.

What's the link between endometriosis and pregnancy?

Peritoneal fluid is the fluid that exists in the abdominal cavity and causes the organs to slide over each other.  Endometriosis changes the cells in this fluid as well as the biochemical content of the fluid. As the volume of the fluid increases, so do the levels of inflammatory cells and prostaglandins. These changes impact the functions of the ovaries and fallopian tubes. Recent scientific studies have revealed that peritoneal fluid has a toxic effect on embryos and stops embryo development at an early stage in cases of endometriosis. This condition prevents the patient from having a normal pregnancy period.

What Exactly Is Adhesion? Why does adhesion occur in conjunction with endometriosis?

Scar tissues associated with endometriosis wounds and inflammatory reactions caused by blood discharge into the abdominal cavity may cause peritoneal adhesions. These adhesions are most commonly found in the reproductive organs and between organs with limited mobility. These adhesions can be seen between the lateral walls, the last parts of the uterus and the large intestine, and the peritoneums, which cover the back of the uterus in particular.

How Is Endometriosis Detected?

The most safe method of diagnosing endometriosis wounds today is direct laparoscopy. The patient’s medical history may indicate the presence of endometriosis, and the examination can be supported by pre-diagnosis. Endometriosis, on the other hand, should be seen directly in order to make an accurate diagnosis. While this procedure was previously used during an open surgery called laparotomy, the exact diagnosis of endometriosis can now be made with laparoscopy.

Endometriosis Treatment In IVF Patients

The general approach is to clean all endometriosis wounds discovered during laparoscopy and then wait for pregnancy to occur. In case that a pregnancy does not occur in the first 6 months, a medical treatment can be started. In this case, IVF treatment steps in. If all of the focuses cannot be cleaned with laparoscopic surgery, a drug therapy will be initiated immediately after the laparoscopy. In some cases, current endometriosis wounds are guaranteed to shrink with medical treatment before laparoscopic endometriosis treatment is applied. This approach may make the surgical procedure performed during laparoscopy easier. Following that, IVF treatment can begin on the date that your physician deems appropriate. Individuals who have had endometriosis surgery have a higher chance of having a baby.