Endometriosis is a condition where tissue similar to the tissue that normally lines the inside of your uterus – the endometrium - starts to grow outside of your uterus in other places, such as the ovaries, fallopian tubes and the tissue lining your pelvis. With endometriosis, the endometrial-like tissue acts as endometrial tissue would, it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit your body, it becomes trapped[1]

Endometriosis can cause pain, sometimes severe, especially during menstrual periods. If you are experiencing pain in your lower tummy or back (pelvic pain) that stops you doing your normal activities, pain during or after sex, pain when peeing or pooing during your period, feeling sick and constipated you should consult your doctor.[1]

Endometriosis can also cause fertility problems, and it is believed this is because of damage to the fallopian tubes or ovaries.[1][2]

When an egg is released from one of the ovaries, it travels through one of the fallopian tubes, which are narrow ducts that connect the ovaries to the uterus. Normally, the egg will join with the sperm in the fallopian tubes during conception and the now-fertilized egg will continue on to the uterus. However, the fallopian tubes are extremely fragile. If they are blocked, there's no way for the egg to become fertilized by the sperm.[2]

An HSG (Hysterosalpingography) may help your doctor to evaluate whether your endometriosis has caused any damage such as hydrosalpinx (fallopian tube is blocked and filled with serous or clear fluid), fallopian tube occlusion, peri-tubal adhesions, deep infiltration of endometrial tissue in the tube and/or in the uterus, which may potentially make it more difficult for you to become pregnant.[3]

An HSG is used to see if your fallopian tubes are open (patent) and if the uterine cavity is normal. A clear fluid called contrast medium is slowly infused into your uterus and tubes while images are taken using x-rays.
 A diagnosis of endometriosis doesn’t necessarily mean that you’re infertile, and there is no harm in trying to get pregnant on your own. But, if you are struggling conceiving, there are many solutions and your doctor will help to determine which one is the right one for you![4]

[1] https://www.nhs.uk/conditions/endometriosis/ (consulted March 10, 2021)

[2] https://www.webmd.com/women/endometriosis/endometriosis-and-fallopian-tube-problems (consulted March 10, 2021)

[3] https://www.endonews.com/worrying-signs-of-endometriosis-on-hysterosalpingography (consulted March 10, 2021)

[4] https://www.pennmedicine.org/updates/blogs/fertility-blog/2016/august/endometriosis-and-fertility (consulted March 10, 2021)