Endometriosis & Infertility

Unraveling the Mystery of Endometriosis and Infertility

Source: PRWeb.com

Endometriosis, a condition caused by a back flow of menstrual tissue into the reproductive organs, afflicts over 5 million women in the U.S. Additionally, it is a factor is 25%-50% of all cases of unexplained female infertility. Recent research offers new insights into why some women develop endometriosis and how to treat it more effectively to restore fertility.

NORWALK, CT (PRWEB) July 14, 2005 -- According to the American College of Obstetrics & Gynecology, 5.5 million women in the U.S. have been diagnosed with endometriosis – a condition that is a factor in 25%-50% of all cases of unexplained female infertility. What's more, because its main symptom is pain during menstruation – a common and normal occurrence – and because definitive diagnosis requires invasive laparoscopic surgery, many women go undiagnosed for years, even decades. While the disorder has remained much of a mystery to the medical community, recent research is shedding new light on why women develop endometriosis and how doctors can more effectively treat it to restore fertility.

" Endometriosis is an enigma on several fronts," notes Dr. Mark Leondires, MD, a board-certified endocrinologist and medical director at RMA of CT. He explains that the basic cause of endometriosis is the back flow, or reflux, of menstrual tissue into the reproductive organs, namely the fallopian tubes and the ovaries. "This occurs at one time or another in about 95% of women," Dr. Leondires says, "But only about 5% of women develop endometriosis.
That's the first mystery; why does this occur in some women, but not in others?" Another puzzling aspect of the condition, Dr. Leondires adds, is that endometriosis does not pose an obstacle to fertility for some women, yet for others, getting pregnant is a significant challenge.

Finding the Answers
"Scientists have been working to answer these questions, and as they have begun establishing a better understanding of the disease, we are able to develop more effective treatment protocols for endometriosis- related infertility," Dr. Leondires explains.

For example, because endometrial tissue grows in response to the rise in estrogen during a woman's cycle, researchers have been working to uncover ways to better regulate estrogen levels in women with endometriosis. A new Japanese study, published in the April, 2005 issue of Fertility & Sterility, found that an immune-enhancing compound called Interleukin-6 (IL-6) was effective at regulating those levels.

Other recent studies have pointed to genetics as a differentiator between women who develop
endometriosis and those who don't, as well as between endometriosis sufferers who have difficulty achieving a pregnancy versus those who are fertile. In one study reported in the July, 2003 issue of Endocrinology, Stanford University researchers studied the uterine tissue of fifteen women with endometriosis-related infertility, and found that certain genes which controlled implantation, immune response to the embryo and other pregnancy-related factors were malfunctioning. In addition, the scientists found that a certain enzyme needed to ensure healthy implantation was missing in the women with endometriosis. "These are important
discoveries that have led to new treatment approaches for endometriosis sufferers who want to become pregnant," Dr. Leondires explains.

And research reported in the April 2005 edition of Human Reproduction confirms that oxidative stress can lead to or exacerbate endometriosis. The medical community has suspected such a link for years, theorizing that a healthy lifestyle and diet rich in antioxidants – which can counteract oxidative damage to the body's cells – could protect some women against endometriosis-related fertility.

A comprehensive treatment approach With these new discoveries in mind, Dr. Leondires notes that a comprehensive approach to endometriosis-related infertility is often most successful.

He recommends the following four-step plan:

Surgical Intervention
"Once we determine that endometriosis is a contributing factor to infertility, the first step is often surgery to remove the endometrial tissue that might be blocking the ovaries or fallopian tubes, and any endometrial masses in the uterus" Dr. Leondires explains.

Lifestyle Changes
As with anyone struggling with infertility, patients are also encouraged to adopt healthy
lifestyles and switch to an antioxidant-rich diet of fruits, vegetables and whole grains. "Good nutrition and fitness supports the entire process of infertility treatment," Dr.Leondires notes.

Drug Therapies
Medications can be prescribed that have been shown to ready the lining of the uterus to make it
more receptive to implantation, including the breast cancer drug Letrozole, along with Lupron and Danazol. These have been shown to increase implantation rates when used in conjunction with the next step, assisted reproductive technologies.

ART Approaches
"Once these initial steps have been taken to address the effects of endometriosis on the reproductive system, we tend to see more successful results with assisted reproductive technologies like In Vitro Fertilization (IVF) or Intrauterine Insemination," Dr.Leondires says.

Bio:
Dr. Mark P. Leondires, M.D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the American Society for Reproductive Medicine. Dr. Leondires earned his medical degree from the University of Vermont College of Medicine and completed his
residency in Obstetrics and Gynecology at Maine Medical Center in Portland, Maine. Dr. Leondires completed a fellowship in Reproductive Endocrinology and Infertility at the National Institutes of Health in Bethesda, Maryland.

After completion of his training, he fulfilled his military obligation by serving as the ART Director for the largest and most successful program in the military health care system at Walter Reed Army Medical Center. During this time he was an Assistant Professor at the Uniformed Services University of Health Sciences and clinical faculty for the Combined Fellowship in Reproductive Endocrinology. Dr. Leondires is currently Medical Director
and lead physician with Reproductive Medicine Associates of Connecticut (RMA-CT) in Norwalk. Along with numerous teaching and research activities, Dr. Leondires has published articles in professional medical journals, national consumer magazines and newspapers, as well as abstracts and book chapters. More information about Reproductive Medicine Associates of Connecticut is available at www.rmact.com.