Which statement about endometriosis is true?

• A. Endometrial tissue grows inside the uterus only.
• B. Endometriosis always presents with fever.
• C. Endometriosis cannot cause infertility.
• D. Endometrial tissue grows outside the uterus and can cause infertility.

Answer: (D)

Endometriosis is when endometrial-like tissue grows outside the uterus—in places like the ovaries, fallopian tubes, and the peritoneum—and responds to hormonal cycles. This tissue can bleed, cause chronic inflammation, and form scar tissue and adhesions, which can distort pelvic anatomy and disrupt ovulation, egg transport, and implantation. That inflammatory environment and altered anatomy can lead to infertility, so endometriosis can indeed affect conception. Fever isn’t typical, since fever points more toward infection than the cyclical changes seen with endometriosis. The statement that endometrial tissue grows outside the uterus and can cause infertility is therefore true.