Although traditionally, Endometriosis has been treated as an hormonal disease, it is now more widely accepted that inflammation plays a big role in its progression, spread and symptoms. Including fertility! In fact, inflammation is a key factor in fertility issues, aside from Endometriosis and it is crucial that you reduce inflammation to improve your fertility.

What we are talking about is chronic (all the time), systemic (all organs and tissues) inflammation. And two body systems are involved.

Inflammation is a key ‘weapon’ for the immune system. You’ll have seen it in action when you’ve got a cut: the area around the cut becomes red, a bit swollen and feels warm to the touch. This is one of the ways the immune system protects you from invading pathogens. After a few days the swelling, redness and heat disappears. This is an example of acute inflammation.

So what is causing the chronic, systemic inflammation? Well, it is also caused by the immune system. And when you have Endometriosis, we know that your immune system is just not functioning as well as it should.

• Firstly, you produce large amounts of lymphocytes (white blood cells) but they are ineffective. One of the roles of these lymphocytes is the regulate the immune response – a bit like turning it on and off.
• Secondly, your immune system produces antibodies and anti-endometrial antibodies. Which means that your immune system has labelled your endometriosis as a pathogen, and reacts against it.
• Thirdly, you produce an abundance of pro-inflammatory cytokines. As the name says, they ‘turn up’ the inflammatory response.
• And finally, your immune system produces natural killer cells (responsible for killing pathogens and malignant cells) and macrophages (which clean the body of microscopic debris), but these are ineffective.

The second system involved in your chronic, systemic inflammation is the digestive system.

• Most women with Endometriosis have leaky gut, or gut hyperpermeability (read more about leaky gut here). This means that undigested food particles can get through the gut wall into the blood stream. These food particles are not meant to be there and they trigger the immune system.
• Your gut microbiome (the balance of good and bad bacteria) is also out of balance. This is called dysbiosis. The good gut bacteria create lower the pH in your gut which makes it an environment that’s difficult for bad bacteria to survive in. But you don’t have enough of the good guys, and too much of the bad one. And bad bacteria produce endotoxins, which trigger the immune system.

Now what does this have to do with fertility?

Inflammation is what I call the ‘engine’ behind your Endometriosis. And Endometriosis has a direct effect on your fertility (more about this in an upcoming article on egg quality).

A really interesting study into infertility showed that women with inflammatory bowel disease had much lower fertility rates than women without this disease. The researchers noticed that the uterine wall was also inflamed in these women and they were convinced that this contributed to the embryo not being able to implant.

So a key strategy for improving your fertility needs to be to reduce inflammation by improving implantation chances and by reducing Endometriosis and therefore improving egg quality.

If you are worried about your fertility, why not book a free 30-minute Endometriosis SOS Call to discuss your options?