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Everything You Need to Know About Endometriosis | Affinity Health

This Endometriosis Awareness Month, Affinity Health, a leading provider of affordable healthcare, connects how Endometriosis management and fertility.


What is Endometriosis?

Endometriosis is a progressive disease in the female reproductive system. It manifests in the tissue that resembles the uterine lining outside the uterus. As the illness worsens, endometriosis can cause damage to the surrounding reproductive organs. Endometriosis impairs reproductive function, increasing the difficulty of sperm reaching an egg.


Although endometriosis may not always result in infertility, it can affect fertility in a significant number of women. According to experts, around half of women experiencing infertility also have endometriosis.


Endometriosis can also impair fertility in the following ways:
  • Obstructing the implantation of an embryo
  • Scarring the Fallopian Tube
  • Influencing the development of eggs
  • Creating hormonal imbalance
  • Resulting in persistent pelvic inflammation

What are the Different Types of Endometriosis?

Endometriosis is classified into three types:
  • Peritoneal superficial
  • Endometriomas
  • Pervasively infiltrating


These classifications indicate the location of endometriosis on a woman’s body. Additionally, physicians classify endometriosis into stages according to severity. Stage 01 is the least severe and stage 04 is the most severe.

Peritoneal superficial:

The peritoneum is a thin layer of tissue that lines the abdomen. When a woman has a peritoneal lesion, the peritoneum may develop growths or cysts. Typically, doctors diagnose superficial peritoneal lesions as stage 01 or stage 02 endometriosis.


Endometriomas are cysts that develop on the surface of the ovaries or within them. They are dark, fluid-filled sacs that physicians occasionally refer to as chocolate cysts. When a woman develops endometrioma, she typically has stage 03 or stage 04 endometriosis.

Pervasively infiltrating:

In deeply infiltrating endometriosis, endometrial-like tissue forms on organs around the uterus. These include the vagina, bladder, and colon. It is the most severe manifestation of the disease. Doctors typically classify deep infiltrating endometriosis as stage 04. This is when growths or lesions extend 5mm below the peritoneum. Along with endometriomas, individuals with stage 04 endometriosis may have significant scarring in the ovaries, uterus, and rectum.

Endometriosis and Fertility

If a woman with endometriosis wishes to conceive, her doctor may use the Endometriosis Fertility Index to assess her status (EFI).


The EFI is a ten-point scale doctors use to forecast the likelihood of pregnancy and assists in making the best fertility decisions. The scale considers a variety of factors, including your:

  • Age
  • Stage of endometriosis
  • Fallopian tube and ovarian function
  • Duration of infertility
  • Medical background
  • Prior pregnancies

Although guidelines differ by individual, a 2021 study determined that those with a score of 5 or higher may be able to attempt natural conception for 24 months before seeking medical intervention, while women with a score of 4 or less should be referred for assisted reproductive treatment immediately.

What Are the Treatment Options Available for Endometriosis?

Many therapeutic options are available to women with endometriosis. Options tend to be recommended when women cannot conceive after six to 12 months of trying. Doctors will recommend which therapy is best. They will base this on the stage and the kind of endometriosis you have.


“Doctors often advocate conservative treatment first. Surgery is usually the last resort after conservative treatment fails,” says Murray Hewlett, CEO of Affinity Health.


“Treatment options for infertility range. They could encourage the ovaries to produce more eggs for in vitro fertilisation. Your unique circumstance determines which treatment is best for you.

Learn More: Reproductive Factors You May Not Know

About Affinity Health

Affinity Health is South Africa’s leading provider of health insurance, offering you a range of options at affordable rates including access to the widest national provider network. We understand the importance of having medical insurance that meets your needs, your budget, and your lifestyle. Our range of healthcare products is designed to protect you and your family when it matters the most. We strive to give our clients peace of mind and the highest standard of service at all times. For more information, follow us on Facebook, Twitter, and Instagram.

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