A symptom such as pain at menstruation may not be seen as unusual, explains Mary Lou Ballweg, executive director of the Endometriosis Association. So she just lives with it and doesn't see a doctor until the symptoms become unbearable. Some young women with endometriosis have apparently normal menstrual periods for years before having discomfort and pain. Others report they've nearly always had difficult periods. As many as 30 percent of women who report infertility problems have endometriosis.
Severe endometriosis can lead to infertility in various ways.
In the ovaries, it can produce cysts that prevent the egg's release. In the fallopian tubes, implants can block the passage of the egg. Also, adhesions can fix ovaries and tubes in place so that projections on the tubes can't grasp the egg and move it into the tube. The effect of mild endometriosis on infertility is less clear. The most common way to see whether a woman has endometriosis is by surgical examination using laparoscopy, a fairly simple procedure usually done without an overnight hospital stay.