When you have a period, you actually expel the lining from the uterus in your body. Usually this tissue grows only in the uterus. But the endometrium can also grow elsewhere: outside the uterus, in the ovaries or fallopian tubes. It can even grow in the bladder and intestinal tubes. When this happens, it is called endometriosis. Endometrial growths can agitate organs and other structures that come in contact with them, causing pain. Irritation can lead to adhesions or scar tissue in these organs. Many people with endometriosis have lower abdominal or pelvic pain, especially during menstrual bleeding, while others with endometriosis have no significant pain. Endometriosis and the possible scar tissue can often lead to difficulty conceiving or infertility. In fact, 30 to 50 percent of infertility patients have endometriosis. How to tell if you have endometriosis The doctor needs to know what symptoms are present, but the only way to confirm a diagnosis of endometriosis is to do a minimally invasive surgical laparoscopy. During a laparoscopy, the doctor can see if there are any adhesions (scar tissue) in the endometriotic tissue. Sometimes endometriosis can grow in the ovaries to form cysts, and it is common for patients with endometriosis to grow such cysts. Cysts can usually be seen on ultrasound. Unlike other endometriotic tissues, these cysts or endometriomas may have to be surgically removed, usually mostly laparoscopically. How laparoscopy is done Laparoscopy is called a minimally invasive procedure because the incision around the umbilicus or lower abdomen is small. A small magnifying glass-like instrument (laparoscope) goes into an incision and allows the surgeon to look for endometriosis using a laparoscope with a small camera attached. Some small instruments go in through other incisions to remove endometriotic tissue and adhesions. Because the incisions are so small, there is only a small scar on the skin after the procedure. You can usually go home the same day of surgery and return to your daily activities. As with any surgery for these patients, there are small risks of comorbidities. These risks include bleeding, infection, reactions to anesthesia and damage to the bowel or other organs. However, these risks do not necessarily occur. Can I conceive after surgery Depending on the extent and degree of endometriosis, surgery may improve the chances of conception. However, your doctor will not know exactly how much the chances have improved. If conception does not occur within a reasonable expected time after surgery, a second surgery may not help either, unless there are new problems. This is because a second surgery will not improve the chances of conception by and large. It is important to consider potential comorbidities and compare the cost of infertility treatment with the cost of secondary surgery. Fertility treatment can usually overcome the effects of endometriosis without surgery, but it is not possible to remove the endometrioma.