Endometriosis can you still get pregnant: How does endometriosis affect fertility?
How does endometriosis affect fertility?
What is endometriosis?
Endometriosis is a common condition in which small pieces of tissue that are similar in make-up to the inner lining of the womb (endometrium) grow outside of the womb; for example on the bowel or bladder, ovaries and fallopian tubes and on the lining of the abdomen.
It is thought to affect around two million women in the UK but it is difficult to be sure because some women have no symptoms. Women of child bearing age are affected most commonly. It is not a cancer. You are more likely to have it if your mother or sister had it. It is linked to infertility.
Symptoms of endometriosis
Symptoms can vary with some women not having any at all, and others having very severe pain. The most common symptoms are:
- painful, heavy or irregular periods
- pain in the lower abdomen, pelvis or lower back around ovulation time, but also throughout the cycle
- ongoing pelvic pain lasting six months or longer
- pain during or after sex
- difficulty getting pregnant
- painful bowel movements and emptying of bladder
Women have also reported some other symptoms, which include:
- bleeding from the back passage
- painful abdominal scars or pain around belly button, especially during the menstrual period
- coughing blood (very rare)
The severity of symptoms is often not directly connected to how much disease tissue you have. You can have severe symptoms and only a few spots. Or a lot of endometriosis but no or only a few symptoms.
Keeping a pain and symptom diary can help with diagnosis.
Although some women might not even realise they have endometriosis until they are checked when they have difficulty getting pregnant, others are in great ongoing pain throughout their lives and have rounds of surgery to manage the condition.
How endometriosis is diagnosed
As the symptoms of endometriosis are similar to a range of other conditions, it can be hard to get a diagnosis but if you have one or more symptoms from the first list above, your doctor should suspect endometriosis and offer you an abdominal and pelvic exam.
- The doctor manually feels (palpates) areas in your pelvis and abdomen for abnormalities, such as cysts on your reproductive organs or scars behind your uterus.
- If your symptoms are severe and persistent and/or the pelvic/abdominal exam shows symptoms of endometriosis then you may be referred for an ultrasound scan. This can be done through the abdomen or using a ‘wand’ inserted into your vagina (transvaginal ultrasound). Even if the scan shows no signs, you may be referred for a laparoscopy if your symptoms are severe and persistent.
- Your doctor may refer you to a surgeon to look inside your abdomen for signs of endometriosis using a surgical procedure called laparoscopy. While you’re under general anaesthetic, the surgeon makes a tiny cut near your navel and inserts a small thin lit tube called a laparoscope, looking for endometrial tissue outside the uterus. They may take samples of tissue. Laparoscopy can provide information about the location, extent and size of the endometrial tissue (called implants). If a full systematic laparoscopy doesn’t show any signs, then you do not have endometriosis.
Stages/severity of endometriosis
The American Society of Reproductive Medicine has developed a staging system to classify the severity of endometriosis. The system for defining the stages of the endometriosis looks mainly at how much tissue has grown and where it is, so it doesn’t always reflect the amount of pain you might have or the risk of infertility. It’s possible for a woman in stage 1 to be in pain for example, while a woman in stage 4 has no pain at all.
- Stage 1: Minimal
- Stage 2: Mild
- Stage 3: Moderate
- Stage 4: Severe
Endometriosis treatment in the UK is usually not based on the stage of endometriosis but on symptoms and your own life priorities. If you want to have a baby then your treatment will be different to the treatment of a woman who is not trying to get pregnant because some treatments prevent pregnancy.
Surgery to remove endometrial tissue could improve your chances of pregnancy if it is thought to be preventing this.
What causes endometriosis?
The cause of endometriosis is still unknown however there are some theories which include:
- Retrograde menstruation: The term for when some of the lining of the womb flows backwards through the fallopian tubes and into the abdomen rather than leaving the body as a period. This occurs in most women as a normal monthly process, but normally the body clears the tissues naturally. However, for some this tissue attaches onto pelvic or abdominal organs or wall resulting in endometriosis. It is unclear though why this happens in only some women.
- Genetics: It is more common to be affected by endometriosis if a female member of your family (especially a parent or sibling) has endometriosis. It can occur in women of all ethnicities but is more common in Asian women than white women and it is less common in women of African-Caribbean origin.
- Immune system: It may be that some women’s immune system is not able to get rid of the tissue therefore women with low immune system may be more at risk of endometriosis
- Environmental: Certain toxins in the environment that affect the immune systems and reproductive system are thought to cause endometriosis but this has not been proven in humans yet.
- Lymphatic or circulatory spread: It is possible that some cells of the tissue can travel around the body in the bloodstream or other vessels to different parts of the body
- Metaplasia: This occurs when one type of cell can change and become a different kind of cell; the cause of this is largely unknown.
How endometriosis affects fertility
Although endometriosis can have an effect on your chances of getting pregnant most women who have mild endometriosis are not infertile. An estimated 70% of women with mild to moderate endometriosis will get pregnant without treatment. If you know you have endometriosis and are failing to conceive, talk to your doctor who can advise you or refer you to the necessary fertility specialists.
The exact nature of the link between infertility and endometriosis is unclear but the severity of the condition and location of the tissue appears to have an effect. For example, it is not fully known how a few spots of endometriosis may affect your chances of getting pregnant, but if you have severe endometriosis your chances are likely to be affected by the changes to your anatomy. However, even with severe endometriosis natural conception is possible.
If you have endometriosis and are trying to get pregnant without success, it is important that you get help and support so speak to your doctor about being referred to a gynaecologist or a fertility specialist .
Getting pregnant with endometriosis – treatment
There is no cure for endometriosis but there are treatments to help manage the condition.
Managing the pain
If your endometriosis causes pain and you are taking painkillers, such as non-steroidal anti-inflammatories (NSAIDs), paracetamol or Codeine. You will be advised to stop taking NSAIDs and minimise the use of codeine as they may have an effect on the baby if you conceive.
There are lots of different types of hormonal treatments that can be offered to those who have endometriosis however as they either mimic pregnancy (such as the contraceptive pill) or menopause they are not suitable if you are trying to get pregnant.
Surgery to improve fertility with endometriosis
For those with minimal or mild endometriosis surgery can improve fertility and should be discussed with you if you are finding that you are not able to get pregnant and the condition has been found to be a possible cause of your infertility.
- The most common type of surgery is laparoscopy, also known as keyhole surgery. This involves a thin tube with a camera at the end being inserted into your abdomen through a small cut made in your skin, usually your belly button. Through this camera and possibly additional small cuts around your bikini line either laser or heat or scissors can be passed to remove or destroy the tissue. For this procedure, you will be put to sleep under general anaesthetic so you will not feel any pain. This is an effective treatment but there is a risk of some tissue being left behind or re-growing, so the endometriosis can recur.
- The other type of surgery that can be performed is a laparotomy. This surgery should only be done in very few exceptions as is more invasive with a wider cut along the bikini and removal of the tissue attached to the affected area. Centres of expertise in the UK, organised by the British Society of Gynaecological Endoscopy, are usually able to perform most surgeries using the keyhole method.
Endometriosis can grow back after surgery. Whether this is because it was not fully removed in the first place or whether it re-grew is impossible to tell. However, it does not mean that if endometriosis ‘regrows’ that it will also cause symptoms. Recurrence rates are about 50% over five years.
How long should someone wait until after a laparoscopy to try to conceive?
There is no easy answer to the question of how soon to try to conceive after a laparoscopy. It depends on factors such as how much tissue was removed, where it was removed from, age and previous infertility or babies.
Are there any reliable statistics on chances of conceiving after successful surgery?
The best way of assessing the chances of natural conception is the so-called endometriosis fertility index (EFI), which takes into account factors such as length of infertility, extent of disease and whether the fallopian tube is involved, age and whether or not a pregnancy had occurred in the past. This index should be calculated after the operation by the surgeon.
IVF and endometriosis
Assisted reproductive techniques (ART) such as Intrauterine Insemination IUI) or In Vitro Fertilisation (IVF) are established treatments for endometriosis-related infertility. NICE recommends that IVF is offered after two years of unsuccessfully trying for a baby with endometriosis, assuming other factors such as semen quality and ovulation are normal. The chances of success are lower depending on how severe the endometriosis is however.
Endometriosis, diet and conceiving
Although there are many references in online forums to diet and endometriosis there is little actual research evidence that any foods in particular should be avoid or included in your diet to help with getting pregnant with endometriosis. Reviews of the research that has been carried out have concluded that the results have not shown that diet has an effect. More research into endometriosis and diet has been recommended by NICE.
For your own physical and mental wellbeing however eating a healthy balanced diet with plenty of fresh fruit and vegetables is always advised, along with drinking plenty of water.
Endometriosis and miscarriage
The effect of endometriosis on miscarriage after natural conception is still unclear.
Randomised controlled trials (RCTs) are the highest level of scientific evidence available. To date, there are only two that have looked at endometriosis and miscarriage. Both of these trials studied the effect of key-hole surgical treatment of mild endometriosis on miscarriage, comparing them to a women who did not receive surgical treatment. When the results of these two trials were put together, there was no reduction in the miscarriage rates, suggesting that the treatment of endometriosis has no impact on miscarriage.
There are also two large population-based databases, however, that do suggest that endometriosis is linked to miscarriage. The first is from a Sweden and looks at 24,667 women with endometriosis, and 98,668 women without endometriosis.
It shows that women with endometriosis were 20% more likely to miscarry compared to women that did not. The second database is from Scotland and compared 5,375 women with endometriosis and 8,710 women without endometriosis.
They also found that women with endometriosis are at higher risk of miscarrying compared to those without.
In summary, whilst the randomised controlled trials showed that the treatment of endometriosis had no impact on miscarriage rates, the large population-based databases showed a clear link between the two. With this conflict it is impossible to make a conclusion on whether endometriosis leads to miscarriages or not. There is therefore a great need for higher quality research in order to help us establish whether endometriosis truly has a part to play in miscarriage.
Endometriosis and pregnancy
Complications of endometriosis during pregnancy are rare but there is an increased risk of placenta praevia (low-lying placenta), in which the placenta attaches lower down in the womb. It is also linked to ectopic pregnancy.
Endometriosis and your mental wellbeing
If you have endometriosis that comes with severe symptoms, you will be know that it is a debilitating and life-changing condition, with women often undergoing numerous operations and struggling to conceive. It can have a huge effect on your mental wellbeing, which is often worsened by the fact that there are few external signs of the pain and impact. It is difficult for other people, including employers and managers, to understand what you are going through, and this can mean that they are less sympathetic to your suffering. Endometriosis UK is a charity that supports women living with the condition.
If it is affecting your mental wellbeing to the point where you think you might be experiencing anxiety or depression, talk to a doctor.
Endometriosis and Pregnancy: Symptoms, Risks, Treatment
If you have endometriosis, you know that the condition can be stressful all on its own. But once you start thinking about getting pregnant, it’s completely normal to wonder how endometriosis might affect your ability to conceive — not to mention whether you or your baby will be at risk once you do get pregnant.
Having the facts just might help ease some of your concerns. Here’s everything you need to know about conceiving with endometriosis, plus how it could affect your pregnancy.
What is endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows in places where it shouldn’t — like the ovaries or fallopian tubes, within the pelvis on the outside of the uterus, or, rarely, in other parts of the body. An estimated 11 percent of American women aged 15 to 44 have endometriosis.
Endometriosis growths aren’t dangerous. But they’re painful, and they can affect a woman’s ability to get pregnant.
Who’s at risk for endometriosis?
Endometriosis can affect any girl or woman of menstruating age, but it most often strikes women in their 30s and 40s. It also seems to be more common in white and Asian women compared to Black and Latinx women.
But age and race aren’t the only factors that could make endometriosis more likely. You might also be at higher risk if:
- You’ve never had children.
- Your periods last longer than seven days.
- Your menstrual cycle is shorter than 27 days.
- You have a health problem that blocks normal blood flow during your period.
- You have a family history of women with endometriosis.
Symptoms endometriosis include the following:
- Super intense period cramps
- Chronic aching in your lower back or pelvis
- A deep-feeling pain during or after sex
- Intestinal discomfort
- Painful bowel movements
- Bleeding or spotting between periods as well as digestive problems (like diarrhea, constipation, bloating or nausea, especially during your period)
- Trouble getting pregnant and fertility problems
As for whether the condition can come on suddenly? There’s no clear answer, but experts do know that for many women, endometriosis doesn’t develop until their 30s or 40s. So if you start to notice uncomfortable symptoms that you didn’t have to deal with in your teens or 20s, it’s worth paying attention.
What causes endometriosis?
The exact causes of endometriosis are still unknown. But many experts think that endometriosis is caused by:
- Problems related to period flow — like blood and tissue backing up to the fallopian tubes
- Genetic factors
- Immune system issues
What is known? When blood and tissue can’t exit your body, they can form painful growths and even scar tissue, while tissue that ends up in the ovaries can form endometriotic cysts. And all these growths can lead to discomfort, unpleasant periods and potential problems getting pregnant.
How does endometriosis affect fertility?
Experts are still trying to understand the relationship between endometriosis and fertility. But they suspect that implants of endometriosis tissue might affect the immune system, leading to inflammation and preventing sperm from getting into the egg or allowing an embroyo to develop.
The condition could make it harder for an embryo to implant on the wall of the uterus too. Endometriosis might also cause a woman’s immune system to attack an embryo instead of trying to protect it.
There’s no way to know for sure whether endometriosis will make it harder for you to get pregnant. But it does seem to be the case that the more endometrial growths a woman has, the more likely she is to experience fertility issues.
What are your chances of getting pregnant with endometriosis?
Women with endometriosis can still conceive, but it might take longer or be more difficult. Almost 40 percent of women who struggle with infertility have endometriosis, according to the American College of Obstetricians and Gynecologists (ACOG).
And when a woman with endometriosis does become pregnant, she may be nearly twice as likely to have a C-section, research shows.
Some women with endometriosis have no problem conceiving, while others need help. It’s hard to know which group you’ll fall into ahead of time, so you and your partner should start off trying to get pregnant naturally.
When should you talk to your doctor if you’re running into trouble? In general, couples where the woman is under 35 should seek help after trying to get pregnant for a year, while couples where the woman is over 35 should seek help after six months.
But some experts say women with endometriosis should seek help at the six-month mark, no matter how old they are. Talk with your partner and your doctor to decide what timeframe feels right for you.
If you’re having trouble conceiving, your doctor will perform a basic evaluation to assess your fertility. If your doctor suspects that you may have endometriosis, he or she may recommend a procedure to look into the abdomen and, if endometriosis is diagnosed, try to remove or damage the growths in an effort to improve fertility and decrease pain.
If surgery isn’t enough, the next steps are either in vitro fertilization or intrauterine insemination (IUI). In vitro fertilization is the more successful approach to acheive conception.
As for having a second child, your experience getting pregnant the first time won’t necessarily predict how things will go in the future. Pregnancy suppresses many of the inflammatory processes that are related to endometriosis, so it’s possible that getting pregnant a second time might even be easier.
Still, that’s not always the case. If you conceived after undergoing surgery to remove endometrial growths, it’s possible to develop new growths that cause problems the next time around.
What are the treatments for endometriosis?
If you think you might have endometriosis, start by talking with your doctor. Endometriosis can sometimes be mistaken for other conditions that cause pelvic pain, like pelvic inflammatory disease, ovarian cysts or even irritable bowel syndrome (IBS). But the right tests can confirm what you’re dealing with and help you get the appropriate treatment.
Your provider will conduct a preconception checkup or a pelvic exam to screen for the condition. If your practitioner suspects that endometriosis is a possibility, he or she will recommend a minimally invasive surgical procedure called a laparoscopy to get a better look inside the pelvic area and confirm the diagnosis. Ultrasounds and pap smears may also give your doctor a heads-up about abnormal growths.
There’s no cure for endometriosis. But addressing your symptoms can increase your odds of conceiving, not to mention reduce your pain and improve your quality of life. So it’s important to get treated.
Practitioners will use medications like gonadotropin-releasing hormone (GnRH agonists), oral contraceptives and synthetic forms of progesterone to treat symptomatic endometriosis. Stopping the patches from growing could make it easier to conceive after you stop taking the medication.
Your doctor might also recommend surgery to remove existing growths and improve youe odds of getting pregnant. If surgery isn’t effective in helping you and your partner conceive within six months, your doctor might recommend IVF or IUI.
IVF can help bypass the problems that make it harder to get pregnant with endometriosis — like the ability of the tubes to pick up the egg and the sperm reaching the egg. Using a GnRH agonist with IVF may improve outcomes. It temporarily stops your body from making hormones that trigger ovulation and spur the growth of endometriosis patches.
Some doctors recommend IUI with fertility drugs such as Clomid to maximize the benefit of the procedure.
What are the possible risks of endometriosis to the mother and baby?
Endometriosis can affect conception and up your chances of needing a C-section. It doesn’t necessarily mean you’ll have a high-risk pregnancy, but having the condition could increase the risk of certain problems, including:
Research shows that women with endometriosis are anywhere from 1.6 to 15 times more likely to have placenta previa, where the placenta implants low in the uterus and covers all of part of the cervix. That could make you more likely to need a C-section.
It’s upsetting to think about, but endometriosis can increase the chances of pregnancy loss compared to women who don’t have the condition. But remember that for many women with endometriosis, it is possible to have a healthy pregnancy and baby.
Evidence also suggests that inflammation caused by endometriosis may be linked to a higher risk of giving birth prematurely. While there’s no way to prevent premature labor, your doctor can help you manage your risk factors and increase the chances of carrying your baby to term.
Recent evidence shows that endometriosis can make you somewhat more prone to developing preeclampsia. The good news is that regular prenatal care can often catch the condition in its early stages, when you may be able to control it with lifestyle changes.
Does endometriosis affect your ability to carry a baby to term?
Endometriosis can increase the risk for both miscarriage and preterm birth, as well as bleeding problems.
Those kinds of risks can be hard to deal with. It’s important to keep in mind that, overall, endometriosis-related complications are rare. Most experts agree that the condition doesn’t have a harmful effect on the majority of pregnancies, and there’s no known link between endometriosis and an increased risk of birth defects.
It can be nerve-wracking to wonder how endometriosis might affect your pregnancy. Having the condition might mean you need help conceiving, and you could be at higher risk for some complications during your pregnancy.
But remember: Many women with endometriosis are able to get pregnant — and have healthy, full-term babies. Just be sure to seek medical help early if you are concerned.
Endometriosis? Pregnancy’s Still Possible! | Premier Health
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See a Premier Physician Network provider near you.
If you have endometriosis, you may have more difficulty becoming pregnant. In fact, according to the American Society for Reproductive Medicine, up to half of women with endometriosis may experience infertility. But don’t despair.
You can take steps to improve your chances of a successful pregnancy.
How Does Endometriosis Affect Fertility?
Endometriosis can affect a woman’s fertility several ways:
- Abnormal pelvic anatomy
- Adhesions, or scar tissue
- Scarred fallopian tubes
- Pelvic inflammation
- Improper immune system functioning
- Changes in the hormonal development of eggs
- Embryos that fail to implant in the uterus
- Eggs that don’t develop properly
Boosting Your Chances of Getting Pregnant
“Women with endometriosis can get pregnant,” says Heather Hilkowitz, MD, Hilltop Obstetrics & Gynecology. “It may be a little more of a challenge in some patients depending on how severe the condition is. But there are lots of different ways, medications and procedures that can be used for women who need them to achieve pregnancy in a minimally invasive way.”
If you opt for surgery, your doctor can evaluate your endometriosis and give you a score, which will tell you if your endometriosis is minimal (Stage 1), mild (Stage 2), moderate (Stage 3) or severe (Stage 4). The higher your score, the more difficulty you may have in becoming pregnant.
During surgery, if your doctor sees endometriosis, she will surgically destroy or remove the endometriosis and any scar tissue. If your endometriosis is minimal or mild, removing the affected tissue can increase your chances of becoming pregnant naturally, without any additional procedures.
“Women with endometriosis can get pregnant.”
Understandably, women with more advanced endometriosis (Stage 3 and 4) will have the most difficulty becoming pregnant. But even in these cases, surgery can restore your normal pelvic anatomy so your ovaries and fallopian tubes work more normally. Removing large areas of endometrial tissue with surgery may also boost fertility.
Keep in mind, though, that there is a limit as to how much surgery can improve fertility rates. Every woman’s treatment is different and designed for her specific needs. Ask your doctor to explain all available options to help you get pregnant.
Dr. Hilkowitz talks about how women with endometriosis can get pregnant.
Click play to watch the video or read video transcript.
Women with endometriosis can get pregnant. Certainly may be a little more of a challenge in some patients depending on how severe the condition is. Some women conceive with ease and totally natural way and don’t need any fertility assistance. But fortunately there are many different ways to help women get pregnant if they carry a diagnosis of infertility. Some of the reasons that someone with endometriosis might have a challenge getting pregnant may have to do with the inflammation that the endometriosis has caused inside the pelvis which could lead to scar tissue of the fallopian tubes or the ovaries or the uterus and to make it more challenging for that egg to get to where it needs to be to conceive. Other times their pelvis may look great and not have any problems with scar tissue yet there’s still something biochemically about endometriosis that makes becoming pregnant a bit of a challenge. There are lots of different ways and medications and procedures that can be used for women who need them to achieve pregnancy in a minimally invasive way.
It’s easy to get the care you need.
See a Premier Physician Network provider near you.
Source: American Society of Reproductive Medicine; Heather Hilkowitz, MD, Hilltop Obstetrics & Gynecology
Can I Get Pregnant if I Have Endometriosis?
When you want to have a baby, it’s stressful and upsetting to have difficulty conceiving. Endometriosis, a common condition where uterine fibroids grow outside your uterus, can cause some women to have more difficulty conceiving. But most women with this condition can go on to become pregnant.
The team at Artemis Menstrual Health and Gynecology, led by board-certified gynecologist Julie Madejski, MD, FACOG, offers fertility and conception support to women who have endometriosis. Learn more about how endometriosis can impact fertility and what your options are to improve your odds of pregnancy.
What is endometriosis?
Endometrial tissue typically lines the inner layer of a woman’s uterus. In women with endometriosis, this uterine lining grows in other areas, such as your fallopian tubes, ovaries, or pelvic area.
Endometriosis can be extremely painful, causing pain and cramping during menstruation, urination, bowel movements, and sexual intercourse. You might also experience abnormal uterine bleeding, nausea, bloating, diarrhea, constipation, and fatigue, with symptoms intensifying during your period.
Does endometriosis cause fertility problems?
Endometriosis causes challenges with conception in a third to a half of women with the condition. Some women first learn they have endometriosis after seeking out treatment for infertility.
Can I get pregnant if I have endometriosis?
While conception can be more challenging for some women with endometriosis, it’s possible to get pregnant with endometriosis. The majority of women with this condition are able to get pregnant, either naturally or with the help of fertility treatment.
What treatments are available to help me conceive with endometriosis?
If you’ve been diagnosed with or suspect you have endometriosis and would like to conceive, or you’ve tried to conceive for six months without success, make an appointment with Dr. Madejski for an evaluation. She performs a full assessment of your health and develops a treatment plan to help you get pregnant.
The procedures Dr. Madejski recommends depend on the severity of your endometriosis, age, and personal history. These are some of the many treatments for endometriosis available.
Living a healthy lifestyle
A healthy lifestyle reduces inflammation throughout the body and can help women with mild endometriosis conceive naturally. Aim to eat a healthy diet, exercise most days of the week, and maintain or attain a healthy weight.
Dr. Madejski can perform robot-assisted laparoscopy, a minimally invasive procedure that uses microscopic incisions, to increase your likelihood of conceiving with endometriosis. With da Vinci robot surgical technology, Dr. Madejski begins the procedure by getting a high-definition view of your reproductive organs.
Using this enhanced view, Dr. Madejski finds and removes any visible endometrial tissues or cystic growths outside of your uterus. Removing these tissues significantly improves your ability to conceive naturally.
If you haven’t been able to conceive naturally, you can become pregnant using fertility procedures. Treatments available include medications, intrauterine insemination (IUI) and in vitro fertilization (IVF).
Clomiphene and similar fertility medications improve your chances of conception by causing your fallopian tubes to release additional healthy eggs every month. Instead of one, they typically release 2-3 eggs.
With IUI, sperm is directly injected into your uterus when you’re fertile. Sperm is concentrated in this procedure and in your uterus, which increases your odds of conception.
IVF involves fertilizing your egg with sperm outside of your uterus. The fertilized embryo is then inserted into your uterus.
If you have endometriosis and are having trouble conceiving, know that there are a number of options to help you have a baby. For assistance with getting pregnant with endometriosis, call our Lockport, New York, office today to make your appointment.
Have Endometriosis And Trying To Conceive Naturally? Read These Amazin
Yes, it’s true that endometriosis is one of the leading causes of infertility, with one study claiming that at least 25 percent of women who are infertile have the disease.
“It creates infertility by blocking and destroying normal anatomy in the body,” Dr. Vladimir Nikiforouk, an OB-GYN in East Stroudsburg, PA, explains to The Blossom. It can also, “decrease the number of eggs that a woman can produce.”
But the gloom and doom of that news aside, many women with endometriosis do go on to someday experience the joys of 3 a.m. feedings, explosive diaper changes, and supermarket meltdowns.
If endometriosis is quickly diagnosed and correctly managed, “there is absolutely an increase in successfully getting pregnant naturally,” adds Nikiforouk.
That’s how it happened for Christine Sturla. For years, her out-of-control endo periods kept her in fear of never conceiving.
“I bled through overnight pads that I wore during the day,” Sturla, 36, tells The Blossom. “Super plus tampons maybe lasted an hour. I had giant clots and crippling cramps to the point that my legs would go numb. I was petrified about how it would affect my ability to conceive. I always wanted to be a mom and was so scared this would prevent that.” In 2012, she underwent a laparoscopy to remove endometriosis lesions. But the New Jersey native was in for a big surprise. After only about three months of trying the old-fashioned way, Sturla and her husband discovered they were pregnant and soon after welcomed a healthy baby boy.
Trying for the second one wasn’t as easy. “We planned to try for the second when our son turned one,” recalls Sturla. “The time came, and nothing was happening. My gyno was sure the endometriosis was back, and we scheduled a second surgery.”
One week before her trip to the operating room, Sturla got another big surprise.
After years of battling endometriosis, Lori Brown Finkelstein (above) says she can hardly believe her luck that she’s now pregnant. “I was always in severe pain,” she says. “Always.”
“We were on vacation, and the doctor called to confirm the surgery for the following week and mentioned a urine test for pregnancy, which got me thinking. So once I hung up, I ran out to get a pregnancy test and there it was—pregnant. I called back immediately to cancel the surgery.”
After years of battling endo, Judy Kim could hardly believe her eyes when she peered down at a plus sign. “To be completely honest, I had pretty much given up all hope and was feeling pretty down on myself about the whole thing,” Kim, 31, tells The Blossom. “It took years of trying, so when I finally got pregnant; I didn’t believe it. I must have taken 20 pregnancy tests.”
After twelve years of six back-to-back endometriosis excision surgeries, Lori Brown Finkelstein was told there was no chance she’d be able to get pregnant on her own—by two different endometriosis specialists. “I was devastated,” Finkelstein, 33, tells The Blossom. “I came home and cried so much.” Throughout the years, doctors removed Finkelstein’s endometriomas, or endometriosis-filled cysts, endo on her uterus and adhesions that bound her intestines together. Her last procedure was in August 2016. Still, Finkelstein was told her she’d need to try in vitro fertilization if she wanted to get pregnant. It was sobering news, considering she had just gotten married in March 2017. “I went to see [my endo specialist] in July 2017,” she recalls, “and two weeks later was when I found out I was pregnant.” She’s now due April 15 with a girl.
“We just decided to try, and it happened.”
Get Pregnant With Endometriosis – Treatments
Learning you have endometriosis can come with a mixed bag of emotions. While it can be a relief to have an explanation for the symptoms you’ve been experiencing, you’re likely wondering what this diagnosis means for you. If you’ve always wanted to be a mother, you might also want to know whether you can get pregnant with endometriosis. Kaylen Silverberg MD at Texas Fertility Center is an expert in the diagnosis and treatment of endometriosis. Find out what our Austin endometriosis doctor has to say about conceiving with this diagnosis.
First of all, what is endometriosis, and what are its symptoms?
Before we dive into what endometriosis is, let’s do a quick review of your monthly cycle. Each month, the cells around the egg that you will ovulate create estrogen. This estrogen causes your uterine lining to thicken in preparation for pregnancy. If you don’t conceive that month, your body will shed your uterine lining as a period.
With endometriosis, problems occur because this condition causes the uterine lining to grow outside of the uterus, forming endometrial implants on nearby organs. When you have your period, these implants also bleed, but they have no way to leave the body. This can result in a number of different symptoms.
- Painful periods
- Heavy periods or bleeding between periods
- Pain during sex or when using the bathroom
- Infertility, which can make it difficult to get pregnant with endometriosis
Keep in mind that not all women with endometriosis experience pain. In fact, some women with no pain have severe endometriosis. In contrast, some women with terrible pain only have endometriosis that affects a small area of the body. This is why it’s important to partner with an Austin endometriosis doctor to get the right diagnosis and treatment.
So, is it possible to get pregnant with endometriosis?
Because endometriosis can cause infertility, many women with this condition want to know whether it’s still possible to welcome a baby. The answer is yes. Our Austin endometriosis doctor has helped many women with this diagnosis become mothers.
Having the right diagnosis is the first step to overcome endometriosis and have a baby. Doctors can sometimes diagnose the problem by taking a medical history and performing an ultrasound. However, minimally invasive laparoscopic surgery is the only way to make a definitive diagnosis. During this procedure, the doctor can often perform surgery to treat the endometriosis.
Some women will conceive naturally after undergoing laparoscopic surgery, but others may still need to rely on fertility medications or in vitro fertilization (IVF). Either way, it is still often very possible to get pregnant with endometriosis.
Want to learn more about how you can become a mother in the face of endometriosis? Contact us to schedule an appointment with one of our experienced fertility doctors.
Getting Pregnant with Endometriosis: What You Need to Know: Ulas Bozdogan, MD: Endometriosis Specialist
Endometriosis is a medical condition caused when the tissue that lines the uterus begins to grow outside the uterus, most commonly on the outside of the uterus or on the ovaries, fallopian tubes, or intestines. It affects about 10% of women in the United States.
Unfortunately, endometriosis can impact a woman’s ability to get pregnant and is a primary cause of infertility in women. As many as 40% of women with endometriosis experience some degree of infertility.
However, there’s hope for women with endometriosis who want to get pregnant. Here at Advanced Endometriosis Center, Dr. Ulas Bozdogan uses advanced treatment approaches for women suffering from endometriosis, including nonsurgical and minimally invasive surgical techniques.
How endometriosis impacts fertility
Endometriosis can interfere with pregnancy in several ways.
It may cause cysts to form in the ovaries, which can inhibit their ability to produce healthy eggs.
In addition, endometriosis may trigger the release of inflammatory chemicals that could impact egg quality, attack and kill sperm, and interfere with fertilization and implantation of a fertilized egg in the uterus.
When endometrial tissue grows outside of the uterus, it can lead to the formation of scar tissue, known as adhesions, within the pelvis. When adhesions develop on the ovaries or fallopian tubes, they can interfere with the normal fertilization and implantation processes necessary for successful pregnancy.
Adhesions may also lead to ectopic pregnancy, which occurs when a fertilized egg gets lodged in a fallopian tube rather than traveling to the uterus for implantation. Ectopic pregnancies end in miscarriage and can be dangerous for the mother.
Early diagnosis may help fertility
If you think you may have endometriosis, early diagnosis and treatment could help preserve your fertility in the future. Call Dr. Bozdogan for an appointment if you’re experiencing any of the following symptoms:
- pelvic pain
- severe cramping during or before menstruation
- low back pain during or before menstruation
- abnormal periods, including spotting between periods
- painful intercourse or vaginal bleeding following intercourse
- unusual pain during bowel movements
- blood in the urine or bowels
- trouble getting pregnant
In many women, hormone-based medications help shrink endometrial adhesions. Although you can’t get pregnant while you’re taking these medications, they may help relieve symptoms and protect your reproductive organs from distortions that could lead to fertility problems later.
Taking steps to treat endometriosis may make it easier for you to get pregnant. Although your treatment options depend on the severity and extent of your endometriosis, they may include laparoscopic surgery to remove endometrial lesions or to drain or remove ovarian cysts.
In most cases, Dr. Bozdogan can perform endometriosis surgery using minimally invasive techniques or robot-assisted surgery with the state-of-the-art da VinciⓇ Surgical System.
Women with endometriosis who can’t get pregnant on their own may find success using assisted reproductive techniques, which include:
- Ovulation induction: Oral medications or injections can help your ovaries release eggs.
- Intrauterine insemination (IUI): This is a procedure in which healthy sperm (fresh or frozen) from your partner or a donor is placed in your uterus around your ovulation time. Ovulation induction drugs may be used with IUI.
- In vitro fertilization (IVF): This is a procedure in which eggs and sperm (from you and your partner or donors) are combined in the laboratory. After fertilization, the resulting embryo or embryos are implanted in your uterus.
Although there is no cure for endometriosis, we can work with you to relieve your symptoms and optimize your fertility. To learn more, call the Advanced Endometriosis Center in New York City or Bergen County, New Jersey. Or you can book an appointment while you’re here on the website by clicking the “request appointment” button.
90,000 Treatment of endometriosis in pregnancy
Endometriosis is a gynecological disease that manifests itself in the form of tumor-like growths of endometrial cells (the inner layer of the uterus) in various organs. The process can be genital and involve the pelvic organs, or it can also involve the abdominal organs, including the intestines, bladder, and lung tissue.
This disease occurs in about 10-15% of women of reproductive age.There are often cases when adenomyosis (internal endometriosis) is confused with uterine myoma, since the mechanisms of development in these diseases are outwardly very similar.
Among the factors that increase the risk of developing endometriosis are:
- carrying out a caesarean section during childbirth;
- late childbirth;
- diathermocoagulation of the cervix, with which erosion is treated.
But the exact reasons for the development of this disease are still unknown.
Is it possible to get pregnant with endometriosis
In about half of cases, endometriosis is combined with infertility. The overgrown endometrium can lead to a violation of the release of the egg and negatively affect the work of the ovaries, it can also make it impossible to implant the ovum into the lining of the uterus.
Hormonal disorders in this disease are manifested in a large number of female sex hormones estrogen, which are produced in endometriosis.With a prolonged course of endometriosis, adhesions appear in the genitals, which further increases the risk of infertility. But still, it is quite possible to become pregnant with endometriosis.
Endometriosis during pregnancy
Despite the fact that internal endometriosis prevents the onset of pregnancy, it is not uncommon for doctors to observe endometriosis and pregnancy that develops against the background of this disease in their practice. Of course, it is easiest to get pregnant with grade 1 endometriosis, while the ailment is not very strong.
But still, it should be noted that even if pregnancy occurs with endometriosis, the woman has an increased risk of miscarriage. Most likely, the doctor will prescribe a course of hormones for the entire period of bearing the baby, which will reduce the likelihood of an unfavorable outcome.
Once the placenta has formed, the likelihood of miscarriage is significantly reduced. In order to safely give birth to a healthy child, the expectant mother must listen to all the advice of her gynecologist.
With the right approach to treatment, endometriosis does not affect the development of the fetus.
Treatment of endometriosis in pregnancy
During pregnancy, the hormonal background to some extent “fights” with endometriosis. In a woman, the production of estrogens by the ovaries is sharply reduced in the body, and the corpus luteum, which is formed during ovulation before pregnancy, actively produces progesterone. All these factors contribute to the suppression of foci of endometriosis.
If after childbirth a woman is breastfeeding, then for the entire period of lactation the production of estrogen is also at a low level, which is a natural therapy for endometriosis. For this reason, in some cases, pregnancy, if not completely cures from this disease, then at least provides a long-term remission and suppression of the activity of pathological foci.
However, all of the above does not mean at all that it is permissible to treat endometriosis with the help of pregnancy.The risk of possible complications, not to mention the fact that the disease itself can prevent pregnancy, is much higher than the chances of a favorable outcome. Therefore, you should not think about how to get pregnant with endometriosis of the uterus, and when such a diagnosis is made, it is better to start treatment right away.
Pregnancy after endometriosis
Timely treatment of foci of endometriosis significantly increases a woman’s chances of pregnancy, because modern methods of therapy can not only eliminate the manifestations of foci of the disease, but also remove adhesions that prevent pregnancy.The likelihood of restoring fertility after endometriosis treatment varies over a very wide range, reaching up to 50% or more. Therefore, if the pregnancy was planned, it is necessary immediately after the course of therapy, with the permission of the attending physician, to attempt to become pregnant.
BISEKOV SALAMAT KHAMITOVICH
Surgeon, phlebologist, doctor of the highest category, candidate of medical sciences
Endometriosis – is it possible to get pregnant?
In addition, endometriosis leads to impaired patency of the fallopian tubes due to adhesions or dysfunction of the endometrium of the uterus.And if endometriosis affects the ovary, then the maturation of the follicle becomes impossible. As a result, problems with conception appear , prompting a woman to see a doctor and find out her diagnosis.
How is the diagnosis made?
The doctor will note the patient’s complaints of incomprehensible pain in the organs during menstruation, profuse smearing menstruation, pain in the genital area and during sex, inflammation in the appendages, untreated by many drugs, especially after abortion.
The picture of the disease will be supplemented with examination data – it is desirable that it be carried out before menstruation or immediately after them, and the main thing in the diagnosis is ultrasound. During this examination, the ovaries and uterus and abdominal cavity are checked.
If endometriosis is suspected, a laparoscopic examination will be required – this is an operation under general anesthesia with examination of the uterine cavity, tubal patency and, if endometriosis foci are found, their surgical correction.
Endometriosis is not a sentence
Of course, the disease is treated for a long time and is not easy, but pregnancy and the birth of healthy babies are quite possible.It is necessary to find an experienced doctor and, with his help, go through the entire course of examination and therapy.
Endometriosis treatments are a combination of hormone therapy and surgery. Initially, hormonal drugs suppress their own menstrual function in order to restore the work of all affected organs and systems, to gain strength. This is followed by a laparoscopic (less traumatic) micro-operation to remove endometriotic foci in the tissues. After this operation, the symptoms of endometriosis are most often alleviated and the woman’s ability to conceive and bear a child is restored, and after childbirth, sometimes endometriosis is weakened.
Then a second maintenance course of hormones is given.
The most important thing in the treatment of endometriosis is the restoration or preservation of the integrity of the fallopian tubes and their patency, without this condition, conception in a natural way, alas, will not work.
In addition, it is important to fully restore the work of the ovaries and the maturation of follicles in them, ovulation. This usually occurs during hormone replacement therapy – the ovaries rest and, after the therapy is canceled, they are actively involved in the work.
If endometriosis was started, and the woman was not treated for a long time, the lesions struck the fallopian tubes and formed adhesions on both of them, it will be problematic to become pregnant naturally . When leaving the egg, it will not be able to meet with the sperm in any way – this happens in the fallopian tube, where access is closed.
Then the only methods of conceiving a child will be artificial test tube technologies – in vitro fertilization of your own egg with your husband’s sperm.It is expensive and difficult, but quite possible.
Endometriosis is a serious illness and women should take a very responsible approach to its treatment and prevention. Especially dangerous are miscarriages and abortions – they intensify the manifestations, and pregnancy and prolonged lactation lead to suppression of foci of endometriosis and a stable improvement in the condition. Therefore, there are always chances to give birth – you must not delay a visit to the doctor!
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Endometritis and its effect on pregnancy
Regular examinations for a woman are a necessity, especially if she is planning a pregnancy.In this case, it is important to assess the state of the endometrium of the uterus in order to exclude the likelihood of pathologies.
The endometrium plays a direct role in the correct attachment of the ovum, and if the cells of the inner layer of the uterus have any defects, the onset and development of pregnancy becomes almost impossible.
Among the pathological conditions of the endometrium, endometritis and endometriosis are distinguished. These concepts are often confused, but these two diseases are completely different in nature and the approach to treatment is also significantly different.
With endometritis, the lining of the uterus becomes inflamed, and most often this is facilitated by fungal, bacterial and viral infections that have entered the tissues of the organs of the reproductive system. Among the causes of endometritis, the most common are sexually transmitted infections, abortions, including spontaneous abortion, blowing tubes, childbirth, and the use of an intrauterine device.
One of the factors for the likely development of endometritis is considered to be sex during menstruation.
The danger of endometritis is that in the absence of timely treatment, infertility can develop and it becomes problematic to bear the child.
Types of endometritis
The inflammatory process in the uterus can be acute or chronic.
In acute endometritis, there is a sharp rise in temperature, cutting pains in the lower abdomen, purulent, and sometimes blood-mixed, vaginal discharge. This condition can last up to a week, a woman in this case needs urgent hospitalization.
The most dangerous for a woman’s reproductive function is the chronic form of endometritis. In this case, there are no pronounced symptoms, therefore, only a regular visit to the gynecologist will help to identify the disease.
Pregnancy and chronic endometritis are generally incompatible .
However, if a woman was able to conceive a child, a serious problem arises with carrying it.
In the chronic form of the disease, IVF attempts are also unsuccessful, since the embryo cannot fully attach to the walls of the endometrium, and if the ovum is not attached, then pregnancy is impossible.
A positive result can be achieved only in the case of timely and correctly planned treatment of the disease, after which pregnancy can occur as soon as possible. For the treatment of endometritis, immunomodulators, anti-inflammatory and antibacterial drugs, vitamins, hormones, physiotherapy procedures are used.
After successful treatment of this chronic disease, the endometrium is restored and ready for implantation, so you can safely plan a pregnancy and give birth to a healthy baby.
90,000 features of pregnancy and childbirth with endometriosis of the uterus, treatment in Moscow
Contents of the article
The endometrium is a mucous, inner layer of the uterus, hormonally sensitive tissue that reacts to changes in hormonal levels, is transformed under the influence of hormones, and prepares the uterus for gestation.The ability of the ovum to attach to the wall of the genital organ, the supply of blood and nutrients to the fetus depends on the state of the endometrium. Disease of the mucosal layer negatively affects fertility, can cause infertility, miscarriage. A common disease of the mucosal layer is endometriosis. Endometriosis affects women of reproductive age, occurs in young girls, there are two types: extragenital and internal genital appearance.
Endometriosis can develop unnoticed for a long time, manifesting itself with unexpressed symptoms.Severe symptoms of the disease appear with significant damage to the inner layer of the uterus or the drift of endometrial cells into other organs, tissues with blood flow. To learn more about the disease, to get answers to questions, consultation by e-mail will help.
At the consultation, you can find out: can there be endometriosis and pregnancy at the same time, can you get pregnant if the disease is running, can you get pregnant with endometriosis and myoma.
Is it possible to get pregnant with uterine endometriosis and myoma
The pathological state of the inner layer of the genital organ develops under the influence of hormones, it is believed that the cause of the development of the disease can be a hereditary factor, frequent inflammatory processes of the genitals, IUD, abortion, lack of vitamins, obesity, operations on the abdominal organs.The tissue of the mucosal layer has a large number of receptors with sensitivity to female sex hormones. An abnormal change in the hormonal background, a violation of the ratio of progesterone and estrogen leads to the proliferation of cells in the mucosal layer. The risk of developing the disease increases if a woman is diagnosed with uterine fibroids. Adenomyosis (a form of internal endometriosis) is more common in the external, ectopic form of the disease. With endometriosis, you can get pregnant if the disease is not started.
Adenomyosis has four degrees of damage to the genital organ:
- Submucosal lesion – first degree.
- The depth of the lesion to the middle of the muscle layer is the second degree.
- Damage to the muscle layer to the serous membrane – the third degree.
- The process involves the serous membrane – the fourth degree.
Extragenital pathology is of a small form, moderate severity, severe form, affects organs, tissues of the abdominal cavity, lungs, fallopian tubes, ovaries, conjunctiva, and other organs. Since endometrial cells have receptors for hormones, during menstruation, all endometriotic foci in the body begin to bleed.Adenomyosis is characterized by inflammatory processes, menstrual irregularities, soreness in the abdomen, lower back, rectum, which increases significantly before menstruation. Pain bothers during intercourse.
Adenomyosis is often accompanied by an inflammatory process in the fallopian tubes and ovaries. Adhesions appear in the ovaries and fallopian tubes, which impede the advancement of sperm and egg cells, and the process of egg maturation is disrupted. There is a failure in the ratio of hormones, the production of estrogen increases, the mucous layer becomes defective.If the sperm are able to fertilize the egg, the fertilized egg cannot attach to the defective mucosa. An increase in estradiol levels reduces the functionality of the corpus luteum.
Antibodies appear in the blood, which have a destructive effect on sperm. All these violations lead to miscarriages, infertility. Fibroids accompanying adenomyosis complicates the course of the disease, reduces the chance of conceiving and bearing a fetus. It is possible to become pregnant with endometriosis and associated fibroids, but it will be very difficult to bear the fetus in due time.In order for the pregnancy to occur, to be safely resolved, it is necessary to undergo a diagnosis of diseases, undergo treatment before planning the birth of a child.
How to get pregnant with endometriosis: treatment methods
Fibroids and concomitant endometriosis are a common cause of infertility in young women. Whether it is possible to become pregnant, what methods are used to treat the disease, women will find out when they contact the clinics for the treatment of fibroids. The earlier the pathology is diagnosed, the higher the chance of cure.Therapy depends on the severity of the disease, the degree of organ damage, the degree of development of the adhesive process, treatment can take a long time.
If ovulation is disturbed, the doctor prescribes a course of hormonal drugs; if the patency of the fallopian tubes is impaired, an operation may be necessary. Anti-inflammatory therapy is carried out, organ-preserving methods are used to treat fibroids, including uterine artery embolization. The doctor prescribes hormone therapy to restore the normal mucosal layer of the uterus, which can receive a fertilized egg.Doctors say that you can get pregnant with endometriosis, it all depends on the individual characteristics of the woman’s body. If pregnancy has occurred, the woman should be under the supervision of a doctor, since the pathology of the inner layer of the uterus often causes various complications:
- Ectopic pregnancy. The cause of the ectopic is the inflammatory and adhesive process in the fallopian tubes, ovaries, uterus.
- Decreased elasticity of the cervical tissue. The adhesion process causes a decrease in tissue elasticity, leads to insufficient opening and rupture of the neck of the organ during childbirth.
- Thinning of the muscular layer of the uterus. This condition occurs at the end of the last trimester of pregnancy with adenomyosis with thinning of the walls of the organ, the pathology is dangerous by rupture of the organ. In this case, a cesarean section is indicated.
- Hormone imbalance. High estrogen and low progesterone levels can lead to miscarriage. Progesterone normally suppresses uterine contractions.
Pregnancy after endometriosis treatment
If the treatment of adenomyosis has been going on for several years, after treatment for a long time, conception does not occur, the woman has impaired patency of the fallopian tubes, doctors recommend in vitro fertilization.Pregnancy has a positive effect on a woman’s health. Hormones stop attacking the receptors of the uterus, a period of “rest” begins. The lactation period will continue the state of “rest”, the hormone prolactin will inhibit the secretion of estrogen. There will be a long-term remission, suppression of pathological foci will occur.
Pregnancy after treatment will come quickly or after a long time depends on the woman’s body. When symptoms of pathology of the genital organs appear, it is necessary to make an appointment, undergo examination and treatment.The launched process often becomes the cause of miscarriage, infertility.
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- Aksenova T.A. Features of the course of pregnancy, childbirth and the postpartum period in uterine fibroids / T. A. Aksenova // Actual problems of pregnancy pathology. – M., 1978. – S. 96104.
- Babunashvili E. L. Reproductive prognosis in uterine myoma: dis. Cand. honey. Sciences / E. L. Babunashvili. – M., 2004 .– 131 p.
- Bogolyubova I.M. Inflammatory complications of the postpartum period in women with uterine fibroids / IM Bogolyubova, TI Timofeeva // Scientific. tr. Centre. Ying-that improvement of doctors. —1983. —T.260. – S. 34-38.
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90,000 Endometrium in IVF: answering current questions
The problem of infertility is currently very widespread, and the number of patients with reduced reproductive function has not yet tended to decrease.In this regard, it is very important to thoroughly prepare for IVF programs and correct the existing deviations in the health status of patients. One of the significant success factors is the uterine factor, in particular, the state of the endometrium. What should be the thickness of the endometrium for embryo replanting? What methods of assessing the state of the endometrium are used? And can the quality of the endometrium be improved? We discuss the issues of women’s reproductive health together with the reproductive physician of the Genom clinic in Karaganda, Khonik Natalya Mikhailovna.
What should be the endometrium in order to get pregnant?
Depending on the phases of the menstrual cycle, the endometrium changes its size every month. Each month, the female body prepares the endometrium for the potential reception of a fertilized egg or embryo. The mucous membrane of the uterus periodically thickens, and then returns to its original parameters. Endometrial growth is controlled by the hormones estrogen and progesterone. The thinnest endometrium is during menstruation.As a rule, this figure exceeds 2 mm and does not exceed 4 mm. In the first phase, the volume of the endometrium begins to build up, and its thickness can reach 5–7 mm. As ovulation approaches, the endometrium becomes even thicker – up to 11 mm. At about day 14 of your cycle, hormones start the process of oocyte secretion. During this period, the thickness of the endometrium reaches its peak. Successful implantation largely depends on how ready the endometrium is to receive the embryo. The optimal thickness is considered to be 8-12 mm. But thickness isn’t everything.Much more important is the structure of the endometrium, both with natural conception and with IVF. The structurally high-quality endometrium in the first phase of the cycle consists of three layers, clearly distinguishable on ultrasound: the basal layer, functional and epithelial. In the second half of the MC, the endometrium, on the contrary, should be homogeneous.
What endometrial pathologies are most often treated by patients?
Diverse. This is chronic endometritis, and intrauterine synechiae, and hyperplastic processes, there are also abnormalities in the development of the genital organs.And all these pathological processes necessarily require correction before the IVF program. Of course, different methods of correction and treatment are selected for each case. For example, removing polyps and separating intrauterine synechiae significantly increases the chances of getting pregnant and carrying them.
Is a “healthy” pregnancy possible with endometriosis?
Despite the unfavorable prognosis, which dictates this disease, it is possible to become pregnant with endometriosis.More than half of women have a high chance of getting pregnant and carrying a healthy baby. However, there are also more complex cases (neglected), accompanied by adhesive processes – but even here modern medicine can help. Only extreme situations can be called hopeless cases when the uterus and ovaries are removed due to endometriosis. Therefore, when the first symptoms appear, you need to see a doctor. The universal advice is routine visits to the gynecological office, especially if you are planning a pregnancy.I would also like to note a very important point regarding this disease. Very often we are faced with ovarian depletion after resection of endometrioid cysts. I strongly recommend that patients with ovarian cysts consult a fertility specialist before deciding on surgical treatment. All surgical interventions should be carried out only with the permission of the reproductologist after assessing the ovarian reserve. Currently, we try not to touch edometrioid cysts up to 5 cm, since any surgical action on the ovaries leads to a decrease in the follicular reserve.
What methods of assessing the structure of the endometrium are used today?
In order to study the state of the uterus and endometrium, ultrasound of the small pelvis is most often used, which should be carried out 1-2 clean days after menstruation. This will allow you to assess the structure of the endometrium, its thickness, and also identify the presence of pathological formations. We also use a method such as Paypel endometrial biopsy. The technique is carried out on the 8-11 day of the cycle in order to diagnose chronic endometritis and in the middle of the luteal phase to determine the state of the receptor status of the endometrium and assess the implantation window (that is, an immunohistochemical study is carried out), markers of chronic endometritis are also determined (SD 138).Echo-HSG or hysterosalpingography, in addition to examining the patency of the fallopian tubes, also allows you to assess the state of the uterine cavity, the presence of intrauterine synechiae, polyps, submucous myoma, and identify the presence of an intrauterine septum.
How to improve the endometrium before IVF?
To improve the endometrium before the embryo transfer procedure, the woman receives hormonal drugs. This is a combination of estrogens and progestins, due to which the required thickness and structure of the endometrium is achieved.And, of course, you need to understand that before any IVF program, the endometrium is not the main factor that needs to be worked on. Before planning a pregnancy, a woman should be treated for all chronic diseases. Even a visit to the dentist and the treatment of active caries are of no small importance, since this is a circulating infection in the blood, which is spread by hematogenous means. Fluorography, examination of all narrow specialists, sanitation of foci of infections – all these activities must be carried out before IVF.Positive thinking of patients, confidence in success is equally important.
Endometrioid ovarian cyst | CMC Hospital
Endometrioid ovarian cyst is part of a disease known as endometriosis . The womb is where the baby grows when the woman is pregnant. It is expelled by a special tissue (endometrium). Endometriosis is a condition in which tissue similar to the lining of the uterus begins to spread elsewhere in your body.These areas of tissue are called “implants,” “nodules,” or “lesions.” They are most common:
- on or under the ovaries
- on the fallopian tubes that carry eggs from the ovaries to the uterus
- behind the uterus
- on tissues that hold the uterus in place
- on the intestines or bladder
- In rare cases, tissue can grow on your lungs or other parts of your body
The approach to the treatment of ovarian endometrial cysts has changed significantly in recent years, especially with regard to the treatment of recurrent endometriosis, fertility preservation and the treatment of infertility.
Causes of occurrence
- Artificial termination of pregnancy
- Diagnostic curettage of the uterus
- Genetic predisposition
- Hormonal imbalance
- Chronic inflammatory diseases of the ovaries, uterus and tubes
- Sexually transmitted diseases
- Using an intrauterine device for a long time
- Physiological features of the cervical canal that prevent the free flow of menstrual blood
- Having sex during your period
Who is at risk of developing an endometrioid ovarian cyst? Pathology is most often diagnosed in women aged 30-40 years.But in general, it can happen to any woman who continues her menstrual cycle. Certain factors increase or decrease the likelihood of developing pathology.
At high risk are people who:
- have a mother, daughter or sister who has been diagnosed with the disease
- Menstruation started before 11 years
- short menstrual cycles (less than 27 days)
- Menstrual cycles are heavy and last more than seven days
Those at low risk include those with:
- menstrual periods began in late adolescence
- previously had a pregnancy
- regular sports more than four hours per week
- very low body fat
- Pain in the lumbosacral region
- Lower abdominal pain
- Pain during intercourse
- Pain during menstruation
- General weakness
- Increased body temperature
- Disorders of the digestive system.
However, the severity of pain is not always a reliable way to determine the extent of the disease. You may have mild endometriosis with severe pain, or advanced painless endometriosis with subtle pain. There are cases of misdiagnosis, when the disease is mistaken for other conditions, which also cause pain in the pelvic area. For example, inflammation of organs in the small pelvis. It can be confused with irritable bowel syndrome, which is accompanied by bouts of cramping and diarrhea.These syndromes can make diagnosis very difficult.
Diagnostics of the endometrioid ovarian cyst
If a disease is suspected, the patient should be examined by a gynecologist. You may also need to donate blood for analysis of tumor markers, undergo ultrasound and MRI of the pelvic organs. Surgery remains the only way to know for sure that you have endometriosis. However, your healthcare provider should first ask about your symptoms and medical history.An operation to diagnose endometriosis – laparoscopy. This is a type of surgery that uses a laparoscope – a thin tube with a camera and a light source at the end. The surgeon inserts the device through small incisions in the skin and diagnoses the image obtained on the monitor. The doctor makes a diagnosis based on what the spots of endometriosis look like. You may also need a biopsy to take a tissue sample.
There is no cure for endometrioid ovarian cyst, but there are treatments for symptoms.The attending physician selects the best option based on the results of the examination. Treatments for endometriosis pain include pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and prescription drugs specifically for endometriosis. Opioids are sometimes prescribed for severe pain. Hormone therapy, including birth control pills, progestin therapy, and gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists cause temporary menopause and control the growth of endometriosis.
Surgical treatment is the main therapeutic option. The most effective types of treatment are radical procedures, including adhesiolysis, removal of the cyst along with its capsule and the remaining foci of endometriosis. The operation is performed by the method of laparoscopy. However, small cysts should not be surgically treated, especially in patients over 35 years of age. Surgical treatment can be considered in infertile women and those who have not been able to conceive despite 1-1.5 years of testing, and in cases where in vitro fertilization is not possible.In addition, large cysts larger than 4 cm in diameter should be treated surgically due to the risk of rupture or twisting. Basically, the operation is performed by the method of laparoscopy. Also, in more severe cases, doctors may resort to hysterectomy – surgery to remove the uterus.
The most effective preventive measure for recurrent ovarian endometriosis is unilateral oophorectomy with preservation of the contra-arterial ovary. Such a procedure should be considered in women who are no longer interested in fertility or who have another endometriotic cyst in the same ovary.The role of pharmacotherapy in this matter is rather limited; this should be considered in patients in whom diffuse endometriosis is associated with pain.
Therapeutic agents from the following groups can be used: an estrogen-progestin preparation, gestagens, including progesterone-releasing intrauterine systems and gonadotropin-releasing hormone agonists. Infertile women should get pregnant as soon as possible, and in patients who have not become pregnant or are over 35 years old, in vitro fertilization should be the first choice.
Endometrial polyp | Gynecology | Directions of DSP Medica
Polyps of the endometrium and endocervix – formations, as a rule, benign, which consist of vascular, glandular, fibromuscular and connective components.
When polyps are detected, the patient is prescribed surgical removal of these formations under the control of hysteroscopy or office hysteroscopy.
The reason for the appearance of such a pathology is a violation of the hormonal functions of the ovaries.If the production of estrogen is disproportionately greater than the production of progesterone, there is a greater likelihood of developing an endometrial polyp. With in vitro fertilization, at the stage of ovulation induction, when the patient deliberately takes hormonal drugs to stimulate the maturation of eggs, there is also a risk of polyp, and IVF in this case is postponed until the time when unwanted formations are removed.
Manifestations of endometrial tumors are not pronounced enough, therefore women do not always pay attention to them.They usually manifest as menstrual irregularities. The following symptoms should be a reason to see a doctor:
· Pain in the lower abdomen. Discomfort during intercourse
· Excessive menstrual bleeding
· Bloody discharge after menopause or before and after menstruation in women of childbearing age
These symptoms are common to other gynecological diseases.The symptomatology of mucosal inflammation is similar to the symptomatology of uterine fibroids , therefore scheduled visits to the gynecologist – at least once every six months – are mandatory for a woman at any age.
Usually, the formation of polyps is typical for women 40-50 years old. However, there are times when it is diagnosed in young girls and women who are planning to become pregnant.
If a gynecologist detects polyposis on an ultrasound scan, it is imperative to carry out hysteroscopy and removal of unwanted formations, otherwise pregnancy will not occur.
Since a polyp is a pathological formation attached by a “leg” to the wall of the uterus, blind curettage is undesirable, especially for patients of childbearing age, since in addition to possible complications, the likelihood of recurrent endometrial polyps increases.
After removal of polyps from the uterine cavity, histological examination is mandatory.
After surgery to remove polyps, IVF is performed no earlier than 3-4 weeks later. This time is necessary for the restoration of the uterine lining.Doctors after the operation prescribe a course of treatment with broad-spectrum antibiotics to relieve the inflammatory process and exclude the occurrence of a bacterial infection. In order to avoid recurrence of growths after surgery, the patient is prescribed hormonal therapy.
Polyp and pregnancy
Practice shows that pregnancy can occur even if a woman has polyps. If the pathology is found in a pregnant woman, removal is carried out after childbirth.
However, if a gynecologist or a reproductologist detects this tumor before conception – on a routine ultrasound scan or during hysteroscopy before IVF, the polyp is recommended to be removed. The in vitro fertilization procedure involves a very thorough preparation of the mother’s body. Otherwise, the likelihood of a successful pregnancy is minimized.
Experts are confident that after removal of the polyp and IVF, and a normal pregnancy will proceed without complications and unpleasant consequences.