India, Sept. 20 -- Endometriosis is a chronic gynaecological condition in which tissue similar to the lining of the uterus grows outside the uterine cavity. It commonly affects the ovaries, fallopian tubes and pelvic tissues. Symptoms may include painful periods, chronic pelvic pain, pain during intercourse and, in some women, difficulty conceiving. The condition is associated with infertility, although the exact biological relationship is complex and may vary from woman to woman. It may affect fertility through several mechanisms. Severe disease can cause inflammation, scar tissue and adhesions that distort the normal pelvic anatomy and interfere with the release or transport of the egg. Changes in the pelvic environment may also affect sperm, eggs, embryo development or implantation. However, not every woman with endometriosis will experience infertility. The management of endometriosis-associated infertility depends on several factors, including the woman's age, duration of infertility, severity and location of endometriosis, ovarian reserve and other fertility factors. Treatment options may include expectant management, laparoscopic surgery in selected cases, ovulation induction with intrauterine insemination (IUI), or assisted reproductive techniques such as in vitro fertilisation (IVF). Hormonal treatments used to control endometriosis symptoms generally suppress ovulation and, therefore, are not fertility treatments when pregnancy is desired. Early evaluation can help identify the most appropriate treatment strategy. Women with endometriosis who are trying to conceive should discuss their fertility goals with a gynaecologist or reproductive medicine specialist so that treatment can be individualised. The author of this article is an IVF and fertility specialist at Jindal IVF, SCO 21, Sector 20-D, Chandigarh. She can be contacted at 958-246-9429...