Ovulation pain – Better Health Channel

Summary

Read the full fact sheet

• About one in five women experience pain during ovulation that can last from a few minutes to 48 hours.
• Ovulation pain is usually harmless, but can sometimes indicate various medical conditions such as endometriosis.
• See your GP (doctor) if your ovulation pain lasts longer than three days or is associated with other unusual menstrual symptoms, such as heavy bleeding.

Up to 40% of women experience pain during ovulation. Ovulation pain is usually harmless, but severe pain may indicate other health conditions. It’s good to know there are many practical ways to manage ovulation pain.

What is ovulation?

Ovulation is part of the female menstrual cycle. An egg is released from an ovary and moves along a fallopian tube towards your uterus.

When does ovulation happen?

Ovulation usually happens once each month, around two weeks before your next period.

Ovulation does not happen if you are:

• on the contraception pill
• pregnant
• postmenopausal.

Some women do not ovulate regularly. This is common when you first start getting your periods. It can also happen during perimenopause (the lead-up to menopause). Hormone conditions can also affect ovulation (e.g. polycystic ovary syndrome (PCOS)).

Symptoms of ovulation pain

Up to 40% of women experience pain and discomfort during ovulation. The pain can last from a few minutes to 48 hours.

Women may experience different symptoms of ovulation pain, including uncomfortable pressure, twinges, sharp pains, cramps or strong pain in the lower abdomen.

What causes ovulation pain?

We don’t know exactly what causes ovulation pain, but it may be caused by:

• the surface of the ovary swelling before the egg is released
• the egg being released from a mature follicle (the sac containing an egg).

Getting a diagnosis

In most cases, ovulation pain is harmless. But severe pain in the lower abdomen might mean you have other health conditions (e.g. endometriosis, appendicitis or pelvic inflammatory disease).

Your GP (doctor) may ask about your medical history and do a physical examination to find the cause of your pain. They might also do some tests. For example:

• blood tests
• swabs from the cervix for sexually transmitted infections (STIs) and other bacteria
• an abdominal ultrasound
• a vaginal ultrasound (preferably at the time the pain is occurring)
• exploratory surgery (a laparoscopy or ‘keyhole’ surgery).

Managing ovulation pain

There are many practical ways to manage ovulation pain.

For example, you can:

• relax by having a warm bath, or rest in bed with a heat pack or hot water bottle
• use pain relief or period pain medication (e.g. anti-inflammatories) – ask your GP (doctor) or pharmacist for recommendations
• take the contraceptive pill or other forms of hormonal contraception, as they stop ovulation.

When to see your doctor

See your GP (doctor) if your ovulation pain lasts longer than three days or if it is associated with symptoms such as heavy bleeding or vaginal discharge.

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s HealthExternal Link.

Where to get help

• Your GPExternal Link
• Gynaecologist
• Jean Hailes for Women’s HealthExternal Link
• Women’s health clinic
• Sexual Health VictoriaExternal Link Tel. (03) 9257 0100

• T. Cornforth, T 2017, Mittelschmerz pain between periodsExternal Link, verywellhealth, USA.
• C O’Herlihy, HP Robinson, L De Crespigny. Mittelschmerz is a preovulatory symptom. Br Med J. 1980 Apr 5;280(6219):986.
• eMedicine Consumer HealthExternal Link.

This page has been produced in consultation with and approved
by:

Ovulation pain – Better Health Channel

Summary

Read the full fact sheet

• About one in five women experience pain during ovulation that can last from a few minutes to 48 hours.
• Ovulation pain is usually harmless, but can sometimes indicate various medical conditions such as endometriosis.
• See your GP (doctor) if your ovulation pain lasts longer than three days or is associated with other unusual menstrual symptoms, such as heavy bleeding.

Up to 40% of women experience pain during ovulation. Ovulation pain is usually harmless, but severe pain may indicate other health conditions. It’s good to know there are many practical ways to manage ovulation pain.

What is ovulation?

Ovulation is part of the female menstrual cycle. An egg is released from an ovary and moves along a fallopian tube towards your uterus.

When does ovulation happen?

Ovulation usually happens once each month, around two weeks before your next period.

Ovulation does not happen if you are:

• on the contraception pill
• pregnant
• postmenopausal.

Some women do not ovulate regularly. This is common when you first start getting your periods. It can also happen during perimenopause (the lead-up to menopause). Hormone conditions can also affect ovulation (e.g. polycystic ovary syndrome (PCOS)).

Symptoms of ovulation pain

Up to 40% of women experience pain and discomfort during ovulation. The pain can last from a few minutes to 48 hours.

Women may experience different symptoms of ovulation pain, including uncomfortable pressure, twinges, sharp pains, cramps or strong pain in the lower abdomen.

What causes ovulation pain?

We don’t know exactly what causes ovulation pain, but it may be caused by:

• the surface of the ovary swelling before the egg is released
• the egg being released from a mature follicle (the sac containing an egg).

Getting a diagnosis

In most cases, ovulation pain is harmless. But severe pain in the lower abdomen might mean you have other health conditions (e.g. endometriosis, appendicitis or pelvic inflammatory disease).

Your GP (doctor) may ask about your medical history and do a physical examination to find the cause of your pain. They might also do some tests. For example:

• blood tests
• swabs from the cervix for sexually transmitted infections (STIs) and other bacteria
• an abdominal ultrasound
• a vaginal ultrasound (preferably at the time the pain is occurring)
• exploratory surgery (a laparoscopy or ‘keyhole’ surgery).

Managing ovulation pain

There are many practical ways to manage ovulation pain.

For example, you can:

• relax by having a warm bath, or rest in bed with a heat pack or hot water bottle
• use pain relief or period pain medication (e.g. anti-inflammatories) – ask your GP (doctor) or pharmacist for recommendations
• take the contraceptive pill or other forms of hormonal contraception, as they stop ovulation.

When to see your doctor

See your GP (doctor) if your ovulation pain lasts longer than three days or if it is associated with symptoms such as heavy bleeding or vaginal discharge.

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s HealthExternal Link.

Where to get help

• Your GPExternal Link
• Gynaecologist
• Jean Hailes for Women’s HealthExternal Link
• Women’s health clinic
• Sexual Health VictoriaExternal Link Tel. (03) 9257 0100

• T. Cornforth, T 2017, Mittelschmerz pain between periodsExternal Link, verywellhealth, USA.
• C O’Herlihy, HP Robinson, L De Crespigny. Mittelschmerz is a preovulatory symptom. Br Med J. 1980 Apr 5;280(6219):986.
• eMedicine Consumer HealthExternal Link.

This page has been produced in consultation with and approved
by:

Painful periods: causes, treatment, prevention

The article was checked by the doctor: Sokolova Marina Olegovna

Degrees of pain severity

Pain during menstruation is called dysmenorrhea (outdated names – algomenorrhea and algomenorrhea). According to statistics, approximately 80% of women suffer from menstrual pain of varying severity.

Usually, discomfort develops within the first 4 hours after the onset of menstruation and lasts for 1-2 days. However, in severe cases, pain can occur a few days before the onset of menstruation and continue for several days or until the very end of menstruation.

Dysmenorrhea has 3 degrees:

1. Mild – such pains are insignificant, are observed only on the first day of menstruation, are not accompanied by other symptoms and do not interfere with the usual way of life.
2. Moderate – pain can last up to 2-3 days of menstruation, there are also other signs of malaise (nausea, weakness, headache), and although unpleasant sensations bring discord into the usual rhythm of life, the patient does not lose her ability to work and can go to work or study.
3. Severe – pain develops even before the onset of menstruation and can continue until it ends, the ability to work is significantly reduced or completely lost, the accompanying symptoms are also strongly pronounced.

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Associated symptoms

Painful periods may be accompanied by other manifestations:

• Deterioration of vascular function: manifested by swelling of the face, numbness of the extremities, arrhythmias, headaches and dizziness.
• Emotional and mental disorders: insomnia, drowsiness, irritability, sensitivity to smells, changes in eating habits, depression, bulimia, anxiety.
• Symptoms of disorders of the autonomic nervous system: digestive disorders, bloating, dry mouth, fever, chills, nausea, vomiting, belching, frequent urination, increased sweating, fainting.
• Signs of metabolic disorders: itching, weakness, feeling of cottony legs, edema of different localization.

Classification and causes of dysmenorrhea

Get expert advice:

• Gynecologist
• Pediatric gynecologist

Why menstruation is painful depends on the type of dysmenorrhea. She may be:

1. Primary (spastic functional) – developing without previous pathological changes in the pelvic organs.
2. Secondary (organic) – due to congenital or acquired diseases.

Primary dysmenorrhea often affects adolescents and young women. After giving birth, she is able to disappear. For many patients, the pain subsides after the age of 25. As a rule, primary dysmenorrhea develops 1.5–2 years after the onset of the first menstruation, when the menstrual cycle is established.

The causes of primary dysmenorrhea were established only in the 2nd half of the 20th century. Previously, they adhered to the version expressed by Hippocrates. He believed that the pains were caused by a pathological narrowing of the cervical (cervical) canal, which disrupted the outflow of menstrual blood. However, in the 20th century it was proved that the surgical expansion of the cervical canal does not affect either the presence or the intensity of painful sensations. Then there was a theory that dysmenorrhea occurs against the background of psychosomatic disorders.

And only in the 50s of the last century it was found that the development of pain is associated with the process of rejection of the endometrium (the inner lining of the uterus) during menstruation. Normally, the inner mucous layer of the uterus is replaced by a new one every month. The old one comes out with menstrual blood. The uterus contracts to shed the endometrium.

Then prostaglandins (hormone-like substances) E2 and F2a were discovered. They are produced by the endometrium and are needed for the contractile activity of the uterus. However, in women with dysmenorrhea, these prostaglandins are found in the endometrium, myometrium (the muscular wall of the uterus) and menstrual blood in high amounts or a change in their ratio. An increase in their level entails an increase in myometrial contractions, and a change in the ratio of E2 and F2a causes vascular spasms and impaired local blood circulation, which leads to oxygen starvation of cells and the activity of nerve endings. This contributes to the development of pain. It was found that in women with dysmenorrhea, the frequency of contractions of the myometrium and intrauterine pressure is at least 2 times higher than in patients who do not experience menstrual pain.

Why the production of prostaglandins rises is still not exactly established. The most popular version is that the cause of this process is an increase in the amount of female sex hormones progesterone and estradiol (estrogen). Estrogen levels rise during ovulation, and progesterone levels rise after it.

There is a risk group that includes women with an increased likelihood of developing primary dysmenorrhea:

• Professional athletes, representatives of professions associated with hard physical labor (this type of activity also affects the intensity of pain).
• Patients with a genetic predisposition: if the mother or grandmother suffers from menstrual pain, the risk of dysmenorrhea increases to 30%.
• Nulliparous women.
• Overweight patients.

Also, the development of primary dysmenorrhea can provoke:

• Infectious diseases (including sexually transmitted infections).
• Hypothermia or overheating of the body.
• Stress.
• Emotional and mental overload.

Secondary dysmenorrhea develops against the background of diseases: more often gynecological. These include:

• Congenital anomalies of the uterus: underdevelopment, pathological location (bend).
• Inflammatory processes in the internal genital organs (for example, inflammation of the appendages).
• Endometriosis and adenomyosis – proliferation of cells of the inner lining of the uterus.
• Ectopic pregnancy.
• Polyps, uterine fibroids – benign neoplasms.
• Stagnation of blood in the pelvic organs.

Dysmenorrhea can also be caused by non-gynecological diseases:

• Disorders of the gastrointestinal tract (most often – irritable bowel syndrome).
• Inflammatory processes in the organs of the urinary system.

Help! Pain during menstruation can also develop after pelvic surgery or after insertion of an intrauterine device.

Diagnosis of dysmenorrhea

You should consult a doctor if the pain during menstruation is severe and significantly reduces the quality of your life. And you should immediately make an appointment in the following cases:

• You have developed dysmenorrhea for the first time.
• Pain lasts more than a week.
• The pain syndrome is unbearable.
• Dysmenorrhea is accompanied by an increase in body temperature or an increase in the amount of menstrual flow.

The gynecologist will collect an anamnesis, conduct an examination and prescribe additional studies, which may include:

• Ultrasound of the pelvic organs.
• Tests for sexually transmitted infections.
• Pregnancy test.
• Hysteroscopy (if neoplasms are suspected) – examination of the cervical canal and uterine cavity from the inside using optical equipment.

Based on the examination and the results of the research, the doctor will find out why the menstruation is painful and prescribe the appropriate therapy.

Treatment of dysmenorrhea

If dysmenorrhea is secondary, that is, caused by other pathologies, then these diseases are treated. With primary dysmenorrhea, complex therapy is carried out. Appointed:

• Medications.
• Therapeutic exercise.
• Reflexology.
• Diet (with excessive body weight).

The main drugs used in the treatment of dysmenorrhea can be divided into 5 groups:

1. Gestagens are synthetic analogs of female sex hormones: they help get rid of hormonal fluctuations and reduce the contractile activity of the myometrium.
2. Non-steroidal anti-inflammatory drugs – reduce the level of prostaglandins and reduce pain.
3. Oral hormonal contraceptives – reduce the amount of menstrual flow and uterine contractions.
4. Analgesics – pain relievers.
5. Antispasmodics – eliminate spasms of blood vessels and smooth muscles.

Also, the patient may be prescribed hypnotics and tranquilizers to eliminate signs of emotional and mental disorders.

Prevention of menstrual pain

Moderate menstrual pain that occurs in a healthy woman can be prevented with preventive measures. These include:

• Diet – 15 days before the onset of menstruation, it is necessary to give up salty, excessively fatty, spicy foods and carbonated drinks, and a few days – from coffee; the diet should consist of vegetables, fruits, lean meats, fish and seafood (they contain omega-3 acids that have an anti-inflammatory effect).
• Taking non-steroidal anti-inflammatory drugs 2-4 days before your period (ibuprofen, aspirin, etc.) – these help lower prostaglandin levels, but you should always consult your doctor about taking them, as they can have a negative effect on the mucous membrane stomach, and in some diseases they should not be used or should be used with caution.
• Reasonable physical activity, such as yoga – the pain becomes less pronounced.
• Herbal medicine – the production of prostaglandins decreases with the use of blackcurrant and evening primrose oils, fennel or tea from it can reduce the number of uterine contractions, ginger tea relieves vasospasm (phytopreparations are also taken after consulting a doctor).
• Avoidance of stressful situations and good sleep.

If the pain still arose, then massage of the lumbar and sacral region will help to reduce them.

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Endometriosis – clinic “Medicina”

Endometriosis can disturb a woman only in reproductive age. It is formed due to the fact that the normal tissue of the inner lining of the uterus – the endometrium – is attached to the pelvic organs and begins to grow. The movement of endometrial tissue occurs by throwing tissue into the small pelvis, which leads to pain and infertility.

Until now, experts do not know why some women develop endometriosis. During each menstrual cycle, menstrual blood must exit through the cervical canal to the outside. However, a small amount of menstrual blood penetrates through the fallopian tubes into the pelvic cavity. In women with endometriosis, there is no self-cleansing of the pelvic cells.

Early endometrioid implants appear as small plaques or spots on the surface of the pelvic peritoneum. These spots can be light white, brown, red, black, or blue. The prevalence and extent of invasion of endometriosis is unpredictable. Some women have many endometrial lesions on the surface of the peritoneum or pelvic organs, they can also penetrate deep into the peritoneum and form nodes. Endometriosis can spread to the surface of the ovaries. In this case, endometrioid cysts (endometriomas) or “chocolate” cysts develop. They are called “chocolate” because over time, the blood that accumulates inside the cyst becomes dark brown and thick. These cysts can be as small as a pea or grow to the size of a grapefruit. Endometrial lesions can interact with surrounding tissues and form adhesions called adhesions. Adhesions can “glue” the pelvic organs to the intestines. Adhesions can close the fallopian tubes and prevent the meeting of the egg and sperm. Endometriosis can grow into the intestinal wall or between the back wall of the vagina and the rectum.

Up to 10% of women have endometriosis. Most women with endometriosis have little to no symptoms. Some women experience severe menstrual cramps, chronic pelvic pain throughout their menstrual cycle, or pain during intercourse.

For some women, the only symptom of endometriosis may be infertility.

Often, endometriosis is diagnosed incidentally during laparoscopy for persistent ovarian cysts or for other reasons. Endometriosis can be present both in women who already have children and in young teenage girls. Some experts believe that endometriosis is more likely to occur in women who have never been pregnant. Endometriosis can be found in 24-50% of cases if a woman has infertility and in 20% of cases if chronic pelvic pain is present.

Endometriosis is classified into 4 stages (I – minimal, II – moderate, III – medium, IV – severe) depending on the location, degree and depth of implant penetration; the presence and severity of adhesions; the presence and size of endometriomas in the ovaries. The most common forms of endometriosis are minimal and moderate forms of spread, they are characterized by superficial implantations and a moderate adhesive process. Moderate and severe endometriosis is characterized by the appearance of “chocolate” cysts and a more pronounced adhesive process. The stage of endometriosis does not correlate with the severity of symptoms; in stage IV, infertility is very likely.

Symptoms of endometriosis

menstrual pain

Most women experience moderate menstrual cramps, this is normal. When spastic pains are more severe, this condition is called dysmenorrhea, which may be a symptom of endometriosis or other pelvic pathology, such as uterine fibroids or adenomyosis. Severe pain may be accompanied by nausea, vomiting and diarrhea. Primary dysmenorrhea in the first years after the first menstrual period tends to decrease with age or after childbirth and is usually not a symptom of endometriosis. Secondary dysmenorrhea appears later and increases with age. If secondary amenorrhea occurs, endometriosis can be suspected, but not all women with endometriosis experience pain.

Pain during intercourse

Endometriosis can cause pain during or after intercourse, a condition known as dyspareunia. Deep penetration can provoke pain in the ovaries associated with the presence of cicatricial deformity in the upper part of the vagina. Pain can also be associated with tension of adhesions in the retrouterine space or on the sacro-uterine ligaments connecting the cervix and sacrum.

Infertility

Endometriosis can be found in 50% of infertile women. Patients with moderate endometriosis can become pregnant at a rate of 2% to 4. 5% per month, compared with healthy couples, whose pregnancy rate is 15-20% per month. Infertile patients with moderate to severe endometriosis can conceive naturally at a rate of less than 2%. However, not all women with endometriosis are infertile. For example, most women undergoing surgical sterilization – tubal ligation, endometriosis of varying degrees of distribution is found.

An association between the presence of endometriosis and infertility has been described but not proven. It is not known how minimal to moderate extent of endometriosis can reduce fertility if there is no adhesion. It is assumed that endometriosis changes the internal environment in the pelvis. This theory takes into account inflammation, local immune changes, hormonal changes, fallopian tubes, fertilization and implantation. It is easier to understand the mechanism of infertility in moderate and severe endometriosis, when extensive adhesions occur in the pelvis and this prevents the meeting of the egg and sperm by blocking the sperm in the fallopian tube, disrupting the release of the egg from the ovary and its subsequent entry into the fallopian tube if the tube is broken .

How to diagnose endometriosis?

The diagnosis of “endometriosis” cannot be made only on the basis of the patient’s complaints.

A doctor may only suspect this diagnosis if there are problems with conception, severe menstrual pain, pain during intercourse, and occasional pelvic pain. Endometriosis can also be suspected if there are cysts in the ovaries that do not respond to treatment. Endometriosis occurs in close relatives, such as mother and sister. But remember that in some cases, endometriosis may not have any symptoms.

Gynecological examination

In some cases, already at a gynecological examination, the doctor may suspect endometriosis. But, despite the presence of complaints and data from a gynecological examination or ultrasound, laparoscopy is necessary for the final confirmation of the diagnosis.

Laparoscopy

Laparoscopy is a surgical procedure that allows the doctor to look at all of the pelvic organs and find areas of endometriosis. During laparoscopy, a thin video camera (laparoscope) is inserted into the abdominal cavity through a small incision near the navel. The laparoscope allows the surgeon to see the surface of the uterus, fallopian tubes, ovaries, and other pelvic organs. During laparoscopy, the degree of endometriosis is assessed. A scoring system is used to assess the degree of endometriosis. A score of 1-15 indicates minimal or moderate prevalence. Over 16 points – for an average or severe degree. However, this system does not correlate with a woman’s chances of getting pregnant and with the degree of her pain.

During laparoscopy, the doctor decides on the treatment of endometriosis, for this, surgical instruments are inserted into the abdominal cavity through additional small incisions. With their help, foci of endometriosis are coagulated, evaporated or excised, adhesions and ovarian cysts are removed. During a laparoscopy, a doctor can check the patency of the fallopian tubes by injecting a special medical dye through the cervix into the uterus. If the tubes are open, then the dye will leak from the ends of the fallopian tubes into the abdominal cavity.

Other diagnostic procedures

In some cases, the doctor may use additional diagnostic procedures to diagnose the condition of the pelvic organs, such as ultrasound, magnetic resonance imaging (MRI). These procedures can more accurately characterize the nature of the contents of ovarian cysts, but often the nature of the contents of endometrioid cysts and cysts of the “yellow” bodies looks the same. These methods are useful in diagnosing women with infertility and chronic pelvic pain.

Pain treatment

When prescribing treatment, the doctor will take into account the symptoms of the disease, the results of examinations. Women with mild symptoms can improve their quality of life by making lifestyle changes without resorting to other treatment measures. Hormone therapy may be offered in cases where pain interferes with an active lifestyle, work and family. With this method of treatment, pain usually disappears in 80% of women who have been diagnosed with endometriosis. Hormonal drugs are ineffective for endometrioid ovarian cysts, in which case surgery is necessary. Surgical treatment is also indicated in cases where hormonal therapy has been ineffective or the patient has contraindications to the use of hormones.

Lifestyle change

Some patients note a decrease in pain when performing special physical exercises and using various relaxation methods. Of the non-hormonal medications, ibuprofen and naproxen have a significant analgesic effect. With painful intercourse, changing the position of partners prevents pain caused by deep penetration.

Pregnancy

Although pregnancy has not been proven to cure endometriosis, endometriosis often regresses during pregnancy. This can be facilitated by hormonal changes during pregnancy. However, after pregnancy, endometriosis returns.

Treatment of infertility.

If minimal to moderate endometriosis is suspected, infertility can be overcome with laparoscopy. But when choosing this method, the age of the woman, the duration of infertility, and the presence of pain in the pelvic region should be taken into account. Other factors of infertility, such as male infertility, may also affect the success of the operation. However, if the pain causes significant inconvenience, surgical treatment is mandatory. A mandatory indication for laparoscopy is severe endometriosis.

Surgical treatment for infertility

Laparoscopic treatment of minimal to moderate endometriosis is associated with a small but significant increase in pregnancy rates. In the largest study to date, 29% of women who had endometriosis coagulation had pregnancy, compared with 17% of pregnancies in women who had endometriosis only diagnosed at laparoscopy. There is no evidence that the chance of pregnancy is increased by any method of removing endometriosis lesions: electrosurgery, laser energy, excision, or coagulation.

Medical therapy for infertility

Drug therapy is effective for pain relief in endometriosis, but there is no evidence that oral contraceptives, progestogens, GnRH agonists increase the frequency of pregnancies. Long-term treatment before and after surgery may delay fertility treatment. However, these drugs are effective in reducing pelvic pain and pain during intercourse. Therefore, hormone therapy can improve the quality of life and sexual activity of women with endometriosis.

Expectant tactics

May be offered to young women after surgery for endometriosis. Up to 40% of women can become pregnant in the first 8-9 months after laparoscopic removal of minimal to moderate endometriosis. Assisted reproductive technologies can be offered as an alternative to expectant management or after 8-9 months after surgery in the absence of pregnancy.

The woman’s age is the most important factor when deciding on one or another way to overcome infertility.

Women over the age of 35 have a reduced chance of pregnancy and an increased risk of miscarriage. Therefore, at this age, it is necessary to use more effective methods of overcoming infertility – assisted reproductive technologies (ART). Expectant tactics are not justified.

Assisted Reproductive Technologies (ART)

These include in vitro fertilization (IVF) and intrauterine insemination (IUI). Several studies have shown that the chance of pregnancy increases in women with minimal to moderate endometriosis during ovulation induction (IO) and IUI. Without treatment, the chance of spontaneous pregnancy is 2-4.5% per month. When conducting only IUI – approximately 5%, when using clomiphene citrate and gonadotropins to induce ovulation without intrauterine insemination, the probability of pregnancy is 4-7% per month.

Ovulation induction (IO) and intrauterine insemination (IUI) increase the chances of pregnancy by up to 9-10% during the first 4 months of treatment.

Using only gonadotropins and IUI increases the success rate by up to 15%. The risks of ovulation induction are the risks of multiple pregnancies.

The pregnancy rate when using IVF for endometriosis does not differ from the pregnancy rate for other factors of infertility. The success of ART is primarily affected by the woman’s age. The probability of pregnancy before the age of 35 is approximately 42%, at the age of 35-37 years – 32%, at the age of 38-40 years – 22%, at 41-42 years – no more than 12% (according to the American Society for Reproductive Medicine 2010).

IVF is the most effective treatment for moderate to severe endometriosis, especially in cases of unsuccessful laparoscopic surgery.

Conclusion

Endometriosis affects the lives of millions of women worldwide. It requires the intervention of specialists in case of problems with conception and deterioration in the quality of life with pain. Endometriosis can be a lifelong problem, as pain often recurs after treatment and endometriosis comes back.