Leading Centre for world class Assisted Reproductive Services in Nigeria.

Fertility Talk With Dr Ajayi: Management Of Endometriosis

Fertility Talk With Dr Ajayi: Management Of Endometriosis


A good clinical history and a thorough clinical examination with high index of suspicion help point in the direction of the correct diagnosis. To confirm the diagnosis, it is advised to undergo vagina ultrasound assessment and laparoscopy (a minimal access surgery which employs keyhole camera procedure) is considered the “gold standard” tool. Laparoscopy also allow for classification of the extent of disease and histological diagnosis


 Endometriosis can be managed either with the help of drugs or with surgery. The drugs used for the management are geared towards pain control and reducing the impact of the oestrogen hormone. Unfortunately, one cannot completely cure endometriosis or eradicate the disease by surgery or medications. Following surgery for mild, moderate or severe disease, the chances of recurrence may be as high as 50% in 2 – 3 years. Also, symptoms of pain may recur once the medications are stopped.

There are various ways by which endometriosis negatively influence fertility, these includes; adhesions with anatomical distortion, scarred fallopian tubes, inflammation of pelvic structures, altered immune functioning which affect the fertilization process, changes in hormonal environment of the egg , reduced ovarian reserve which affect the egg release process, altered egg quality and reduced endometrial receptivity.

In those with mild to moderate disease, conception can occur spontaneously. Failure to conceive following 6 – 12 months of trying may necessitate help in the form of assisted conception treatments, mainly invitro-fertilization. Often times there are need for pretreatment evaluation and drug therapy. Fertility treatment protocols must be tailored to the individuals need to achieve the desired outcome.

The Nordica experience revealed that 25% of patients undergoing Assisted Reproductive Technique are affected by endometriosis, and up to 40% of these patients show ovarian endometriosis. During endoscopy surgical procedure at Nordica fertility centre, endometriosis is the third commonest finding (15.7%) at laparoscopy.

With the wealth of experience in the management of this condition; timely diagnosis and appropriate management including the application of laparoscopy, employment of up to date technology for fertility care, provision of appropriate counseling and support as the need arises. We at Nordica affirm that it is possible for those with endometriosis to live above the pain and achieve their desired goals and aspiration despite the condition. YOU ARE NOT ALONE, to this end; Nordica Fertility Centre started ENDOMETRIOSIS SUPPORT GROUP FOUNDATION. The only support group for endometriosis in the West African sub-region since 2005, the invaluable support provided is helping group members to cope well with the challenges of endometriosis.

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