Endometriosis And Fertility

Getting Pregnant

The fine line between fertility and infertility is a significant position for women suffering from endometriosis. Those with mild endometriosis have as much chance of conceiving as any other woman, though, without endometriosis treatment, the probability of pregnancy may decrease for women with severe endometriosis.

Conception Rates

According to various studies done on women dealing with endometriosis, around 75% to 80% of women may succeed in getting pregnant. For women without endometriosis, there is about a 20% to 25% chance of pregnancy each month.
However, if you are suffering from endometriosis in its mild form, where scarring has not yet occurred, the chances are around 7% to 10%. Women with more severe endometriosis who are dealing with extensive scarring, blocking of the fallopian tubes, and even ovarian cysts, are more likely to find it very difficult to conceive without treatment.
The good news, though, is that when a doctor diagnosis your case with laparoscopy, he may also remove the scarred tissues. This may not help in permanent eradication of endometriosis, but for an approximate period of 36 weeks, you can increase your chances of getting pregnant to around 75%.

Causes of Difficulty in Conception

Endometriosis can lead to fertility problems or difficulty in conception due to various reasons. Different women experience different levels of the disease and depending on the area which has been most affected by endometrial tissues, there symptoms may be mild to severe.
Some of the reasons that lead to conception difficulties are:

Laparoscopy

Usually doctors check for abnormal endometrial tissues and scar tissues with the help laparoscopy, which requires a very small incision to be made in your body.
Once the location of tissue growth is identified, doctors can then remove it surgically using the same method. This may not be a permanent solution to the problem, though, but it should provide you with time to conceive.
In cases with more extensive growth, a similar procedure, known as laparotomy, may be used to remove the tissue.

Fertility drugs

Drugs like clomid have been used for a long time in infertility treatments, as they help in inducing ovulation when ovulation doesn't occur naturally.
In the case of endometriosis, some women have difficulty with ovulation due to presence of scar tissue or the abnormal secretion of certain hormones. Through the use of infertility drugs, either orally or by injection, ovulation occurs and the chances of pregnancy increase.

Intrauterine insemination

IUI has found to be helpful for women suffering from endometriosis, particularly when used in conjunction with fertility medications. This method involves injecting sperm directly into the uterus.

In-vitro fertilisation

Infertility for many has become a thing of the past due to IVF. For those suffering from endometriosis, this process can be very helpful as the complete procedure of fertilisation takes place outside the body thereby reducing the chances of endometrial tissue affecting fertilisation. When necessary, ICSI (intracytoplasmic sperm injection) can also be used with IVF to inject a single sperm directly into an egg.

Adhesion

When endometrial tissue is formed on organs other than the uterus, the body tries to prevent this tissue from creating further problems by covering it with scar tissue. The scar tissue can sometimes adhere to nearby tissues or organs, like the ovaries or fallopian tubes, thereby disrupting their functions. Apart from this, the endometrial tissue also secretes blood, which may cause surrounding organs to stick to the same site.
When this kind of adhesion occurs with the fallopian tube or the ovary, their position is displaced and the egg or the sperm cannot travel in the proper way to be fertilised. The chances of ectopic pregnancy also increase in women with this kind of problem.

Scarring

If the growth of endometrial tissue occurs inside the fallopian tubes, there is no place for the tissue to shed. With time, scarring occurs and the inner wall of the tube becomes so damaged that the journey of the egg from the ovary to the uterus cannot occur successfully.
Such kind of scarring may also occur on the ovaries, which can pose difficulties when it comes time for ovulation and releasing an egg.

Prostaglandins

These very important hormones are secreted by the endometrium and can trigger many bodily functions, including ovulation, menstrual cramps, and contraction of the uterus during birth.
For someone suffering from endometriosis, prostaglandin secretion is extremely high and may occur at times when it is not actually required. This can cause various problems while trying to conceive as well as when you are pregnant.
For example, excess prostaglandin in the system can cause the body to think it is time to start menstruating. However, if you are pregnant, this extra prostaglandin will in fact cause a miscarriage, as the embryo is shed from the body along with the uterine lining during your period.

Immune system

Although sperm and an embryo are considered to be “foreign bodies” by a woman’s immune system, normally, there are systems in place that override the body’s normal response of attacking “foreign objects.”
However, many believe that women with endometriosis have an immune system that is somewhat faulty. As a result, it is possible that a woman with endometriosis may have difficulty sustaining a pregnancy because her immune system recognizes sperm and a fetus as a danger and therefore launches an attack.

Painful Intercourse

One symptom of endometriosis is suffering a very painful time during intercourse. If this persists, a woman may find sex a difficult process and therefore cannot conceive.

Treatment Options

In women with milder cases of endometriosis, it is not unusual for a woman to be able to conceive naturally. For those with more extensive endometriosis, though, treatment may be necessary, including surgery or medications.
Many women have also succeeded in conceiving by using alternative treatments like homeopathy, Chinese medicines, herbs, diet plans and self help programmes.

Fertility tips for those with endometriosis

Predicting ovulation using various methods, like charts, temperature, and cervical changes, and having intercourse at the right time.
Changing your diet to include foods that are beneficial against endometriosis and taking care of your overall health.
Having a more positive attitude. Sometimes depression and the thought itself of suffering from a life long problem may make you less willing to try, which can further decrease your chances of pregnancy.
Talking with your partner can help your partner understand your problem better and strengthen your relationship, which in can turn help with the chances of conception.

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