With the discussions relating to women’s health gaining pace, today terms like PCOS, hypothyroidism, and endometriosis are among mainstream conversations. Every woman today is probably more aware of various conditions that can possibly affect them and their fertility.
One of the several causes of infertility is endometriosis. This medical condition is a tricky one to figure out and also treat. It may take several years before endometriosis is diagnosed. And then some time for maintaining optimal fertility.
What is endometriosis?
The endometrium is the innermost layer of the uterus. In women with endometriosis, this uterine layer is often found outside the confines of the uterus. The ovaries, fallopian tubes, intestines, and other possible pelvic organs can have the presence of this uterine tissue. So, since this is uterine tissue, it bleeds and goes through changes, similar to the tissue within the uterus. And this results in painful cysts and adhesions within the abdominal and pelvic cavities.
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The symptoms can differ from woman to woman. Some women can go years without any obvious symptoms. Some of the clinical features include:
- Pain and cramping (excessive than usual during menses)
- Pain during the digestive processes
- Pain during intercourse
- Irregular menstrual cycles
- Heavy menstrual bleeding
- Change (and pain) in bowel and bladder habits
- Debilitation due to underlying symptoms
What is the link between endometriosis and fertility?
While endometriosis is a possible cause for infertility, most women with endometriosis are able to conceive without any requirement for fertility treatments.
There are several ways in which endometriosis can hamper your ability to conceive. Some possible ways include:
- Cyst formation
- A decrease in the functioning of organs (ovaries) due to external endometrial tissues
- Inflammation affecting eggs and sperm
- Inflammation preventing the release of the eggs
- Pain affecting intercourse
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While these are the most common underlying reasons, there could be any series of events that could hinder the process of fertilization in women with endometriosis.
Can I get pregnant if I have endometriosis?
Many women often get pregnant without even knowing that they could possibly have endometriosis. However, when you do have difficulty in getting pregnant (over a year after trying to conceive) checking in with a fertility expert is crucial.
Endometriosis is diagnosed through a laparoscopy. This procedure is also useful in treating the condition as well. Some of the extrauterine tissues can be removed when identified through laparoscopy. Additionally, your physician can decide the severity of your condition to suggest other fertility treatments.
Approach to infertility related to endometriosis includes:
- Women with mild endometriosis can opt for medical management to facilitate ovulation. A few lifestyle changes, which includes maintaining optimal weight and tailoring your diet accordingly can help with the fertility process.
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- Some doctors suggest freezing viable eggs, as these can get affected as endometriosis progresses.
- Many women achieve success through in vitro fertilization.
How does endometriosis affect pregnancy?
Endometriosis symptoms may improve following pregnancy, this is because a woman is not menstruating when she is pregnant.
However, this might not be the case for all women. Some women might observe an increase in the growth of the endometrial tissue. Additionally, endometriosis does add some risks to your pregnancy:
- Preterm delivery: Women with endometriosis are more likely to undergo preterm delivery, which usually happens before 37 weeks of pregnancy.
- Miscarriage: Just like preterm delivery, endometriosis increases a woman’s chances of undergoing a miscarriage. This is usually identified through bleeding, cramping, and lower back pain. Miscarriage is often classified as a loss in pregnancy within the first trimester (12 weeks).
- Placental complications: The placenta provides nutrition to the growing baby. There is an increased likelihood for women with endometriosis to develop something known as a placenta previa. This is when the placenta covers the opening of the uterus. There is also an increase in the chances of premature separation of the placenta linked with endometriosis.
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- Increased chance of cesarean deliveries: Due to the increased risk of complications linked with endometriosis and pregnancy, women with endometriosis have a higher chance of undergoing cesarean delivery.
These are just a few of the complications that are documented with endometriosis. There is large spectrum of obstetrical complications that can be associated with endometriosis. You will ideally have to follow up with your gynecologist regularly during pregnancy if you have endometriosis.
Bleeding, contraction, excruciating backache, or anything new and concerning requires immediate medical attention.
Does endometriosis go away?
The underlying cause or reason for endometriosis is often obscure. Therefore while the extrauterine tissue may not go away, symptoms related to endometriosis can subside on its own.
Certain women might experience relief with small lifestyle changes or medical management. Some may experience relief following a laparoscopic intervention. But for most women, they observe waxing and waning symptoms throughout their lifetime.
Temporary relief might be observed during pregnancy. However, most symptoms subside during menopause. This is due to the decrease in the primary reproductive hormones following menopause. This results in the reduction of cyclical pain observed during menses as well as a reduction in the size of the endometrial tissue is observed.
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It is often disheartening to get a medical diagnosis such as endometriosis. More so if it has an impact on your fertility. However, today with the advances in medical science and a variety of options, women are able to manage their symptoms and increase their chances of fertility. Often seeking help in the initial phases when you feel that something might be amiss is crucial.
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