Role of Endometrium in Infertility

The endometrium plays a very important in the female reproductive system. Sheela was married for more than a year and faced problems in conceiving. As days and months passed, she was getting more and more depressed. One day, seeing her disheartened, her husband decided to take her to a fertility clinic. Residing in Bengaluru they decided to visit GarbhaGudi, one of the leading fertility specialist clinics. 

Consulting one of the well-versed doctors at GarbhaGudi, who diagnosed her with endometriosis. She was puzzled about the disorder so the doctor explained to her in detail the role of endometrium in fertility.

The endometrium is the tissue that lines the uterus, also known as the womb, which is a pear-shaped organ that will contain a fetus at the time of pregnancy. In preparation for a possible pregnancy, this mucous membrane thickens. The lining remains in place when a fertilized egg is implanted. Otherwise, the endometrium thins and sheds during a menstrual period.

Endometriosis (tissue growing outside the uterus), hyperplasia (lining thickening), and cancer can all be caused by abnormalities in the endometrium, often known as the endometrial lining. The endometrium is largely made up of mucosal tissue. It consists of two layers. 

• The first layer, the stratum basalis, connects to the myometrium, a layer of smooth muscle tissue in the uterus. This layer serves as an anchor for the endometrium within the uterus and remains basically unaltered.

• The second layer is more dynamic. It varies according to the monthly flux of hormones that govern the menstrual cycle. As the result, it is known as the stratum functional or functional layer. It is the endometrial region where a fertilized egg (or blastocyst) will implant if fertilization occurs.

The functional layer of the endometrium undergoes certain modifications just before ovulation (the release of an egg from a fallopian tube). Uterine glands become longer, and microscopic blood vessels proliferate—a process known as vascularization.

As a result, the endometrial lining thickens and becomes rich with blood, preparing it to receive a fertilized egg and also to support a placenta—the organ that forms during pregnancy to deliver oxygen, blood, and nutrition to the embryo.

Remember that people who are too young to have had their periods yet, as well as those who have gone through menopause, will not experience these changes. Their endometrial linings will remain steady and rather thin.

Hormonal contraception can have a similar effect. People who use progesterone-only contraception, such as the Mirena intrauterine device or the Nexplanon contraceptive implant, which both eventually inhibit the development of the functional layer of the endometrium, have lighter periods.

If conception does not occur after ovulation, the accumulation of blood vessels and tissues is rendered unneeded and is shed. This is your menstrual cycle.

Most of the time, the ebb and flow of the endometrial lining follow a pretty regular rhythm—as everyone who menstruates knows. However, endometrial lining abnormalities can change this. Here are the most prevalent ones that women may encounter.

As it thickens, the endometrial lining can migrate outside of the uterus and deposit itself on the ovaries, fallopian tubes, or pelvic tissue. This tissue will continue to develop and then break down even if it is outside of the uterus. The difficulty is that because it is misplaced, blood and tissue have nowhere to escape and get stuck. Endometriosis can eventually result in cysts on the ovaries known as endometriomas, as well as scar tissue and adhesions that cause tissues in the pelvis to cling together.

The primary symptom is extreme pain, which can occur not just during menstruation but also during intercourse, bowel motions, or urine. Periods can be painful, and you may feel exhausted, bloated, or nauseated.

Endometriosis will cause infertility in approximately 40% of women, due to a variety of complications ranging from scar tissue and adhesions in and around the fallopian tubes to low progesterone levels that can interfere with the formation of the uterine lining—a condition known as luteal phase defect.

Endometriosis can be treated with medication, hormone treatment, or surgery, but it can still have an impact on fertility.

The uterine lining thickens in this situation. This is typically caused by a hormonal imbalance. If ovulation does not occur, an excess of estrogen, which induces endometrial thickening, can occur in conjunction with a lack of progesterone. The uterine lining is not shed under these conditions, and cells within it continue to proliferate.

Endometrial hyperplasia can develop during perimenopause, when ovulation becomes erratic, or during menopause when the menstrual cycle ceases entirely. It can also happen in persons who use estrogen-like drugs (without progestin or progesterone) or who take high dosages of estrogen after menopause for an extended length of time.

Other risk factors include irregular menstrual cycles, especially in those with polycystic ovarian syndrome (PCOS), infertility, or obesity: Extra fat cells also create excess estrogen. This can result in an increase in endometrial growth and, eventually, heavier periods.

Endometrial cancer is caused by abnormal cell proliferation. Approximately 90% of those diagnosed with this illness experience abnormal vaginal bleeding. Non-bloody vaginal discharge, pelvic discomfort, a sense of a lump in your pelvic area, and unexplained weight loss are all possible indicators of endometrial cancer.

Eventually, after knowing all the details about the disorder, Sheela now decided to get treated at GarbhaGudi and have a family through IVF. 

Founded in Bangalore, GarbhaGudi is a franchise of reproductive health clinics lauded for their excellent success rates, ethical goals, and humane approach to care. Thanks to our innovative and evidence-based care, we have helped over 8500 families become complete.

To satisfy all of your needs, we have created a team of highly competent fertility doctors, embryologists, and paramedical professionals. Our attitude is that "every couple who walks in should walk out with a smile and a healthy baby."