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Endometriosis and Its Impact on Fertility

April 5th, 2019
ConceiveAbilities - Endometriosis and Its Impact on Fertility

Endometriosis can often be a very misunderstood and often misdiagnosed medical condition even though it affects one in ten women and 25% to 50% of women who deal specially with an infertility diagnosis. In recent years, many female celebrities such as Lena Dunham, Julianne Hough, Padma Lakshmi, Daisy Ridley, Tia Mowry-Hardrict and Halsey have all opened up about their own endometriosis diagnosis in the hopes that it raises awareness and helps others like themselves.

Making matters more frustrating, endometriosis is sometimes mistaken for other conditions such as pelvic inflammatory disease (PID) or ovarian cysts. It may also be confused with irritable bowel syndrome (IBS). In other cases, 20–25% of patients are completely asymptomatic.

This is why the more familiar you become with this condition and its symptoms, the more you can advocate on your own behalf.

What is endometriosis?

Endometriosis is a disease where the tissue that lines the uterus, known as the endometrium, is found outside of the uterus. This lining may be found throughout the entire pelvis area, including the fallopian tubes, ovaries, bowels, bladder and even in some cases, the appendix, causing intense inflammation and pain. Symptoms can vary from patient to patient, but common symptoms are severe menstrual cramps, painful intercourse, heavy or irregular periods and potential infertility. The severity of endometriosis can vary from patient to patient, so endometriosis may or may not have an impact on a woman’s quality of life or her fertility.

Can you get pregnant if you have endometriosis?

In general, the rule of thumb for anyone trying to conceive is if you’re a woman and under the age of 35 years old, it’s recommended you try to conceive for a year before seeing a reproductive endocrinologist and if you’re over 35 years old, you should see one if you’ve been trying to conceive for over six months.

If you already know you have endometriosis, the difference is to try conceiving naturally for six months (rather than the above mentioned recommended twelve months). Still, just because you have endometriosis doesn’t mean you may not conceive on your own as it’s entirely possible you can still get pregnant naturally. However, you should always feel comfortable seeking the advice or insight of your OB/GYN or even make an appointment with a Reproductive Endocrinologist if you feel you need some extra support or guidance.

On that note, if you do get pregnant, some women report that pregnancy actually relieves some of the symptoms of endometriosis. It’s important to mention though that pregnancy does not “cure” the disease as much as it offers a respite. Still, it would be a welcome break!

Can endometriosis cause permanent infertility?

Each case of endometriosis can vary woman to woman and the same goes for the severity of symptoms and the impact it has on her fertility. Some women, as we mentioned, may be able to conceive on her own and some may need reproductive technology to help her expand her family. While it can seem intimidating or overwhelming to consider using infertility treatment to conceive, when you consider that it changes the question from “if” I’ll have a family to “how” I’ll have a family, things seem more hopeful. The bottom line, while it may potentially impact your fertility, you always have options like IVF, surrogacy, adoption and more to consider.

How does endometriosis affect implantation?

When you’re trying to conceive, the embryo that’s created needs to implant itself into the uterine lining to achieve a successful pregnancy. As you learn and understand more about endometriosis and how the uterine lining may or may not be compromised, you may be concerned about whether an embryo (whether it’s created through natural conception or IVF) may be unable to implant. In a study done by Yale University on this exact concern, it did show in some cases there might be a lower implantation rate. However, reproductive technology is constantly evolving and recently, a new test emerged that looks at endometrial receptivity that can offer the optimal time to transfer an embryo.

Does endometriosis affect IVF success rates?

There are a lot of factors when it comes to answering this question. It depends on the severity of the endometriosis, how it was treated previously (meaning, if surgical measures such as laparoscopy was used prior to the IVF cycle) and how much time has lapsed in between surgery and the IVF cycle. A study was done about this exact topic by The Journal of Minimally Invasive Gynecology and overall, the biggest factor appears to be how intense the endometriosis is. This is another reason why early diagnosis and intervention, if at all possible, can be incredibly helpful.

What is the treatment for endometriosis?

Typically, depending on how severe the endometriosis is suspected to be, the first lines of defense are over the counter pain medications like Advil, Motrin, Naproxen or Aleve. Hormone treatments are an option as well such as birth control pills. In general, these treatments aren’t always sufficient for endometriosis since diagnosis tends to require surgical confirmation. Surgical options range from the earlier mentioned laparoscopy to a slightly more invasive procedure called a laparotomy. Typically, a skilled surgeon can diagnose and treat endometriosis with minimally invasive techniques.

Does treating endometriosis increase fertility?

Depending on the course of action taken, surgical intervention may help. With endometriosis, there really is no, “one size fits all” and that’s why getting the proper diagnosis and having your treatment specially tailored to you is what will help you have the best possible outcome not just to potentially increasing your fertility, but to having a healthy pregnancy and child.

In the end, educating yourself, keeping track of your cycle and the corresponding symptoms, partnering with an expert clinic and persistence can make a tremendous difference. And remember, you can use ConceiveAbilities as a resource to learn about all of your family building options! Get started by clicking here now.