Overcoming An Endometriosis Diagnosis
Finding out you have endometriosis is hard enough, but finding out it may alter your plans for a family can be even harder.
However, an early diagnosis, a careful treatment plan, and ongoing monitoring from your doctor should help you move toward the future youve been dreaming of, whether thats pain-free periods, the perfect family, or both!
Getting Pregnant With Endo
What should you do if you have endometriosis and youreready for a baby?
- Talk to your doctor: Your plan of actiondepends on a lot of factors, including how old you are, how long youve beentrying to get pregnant and how advanced the endometriosis is, says Dr. Attaran.Get a doctors opinion based on your particular situation.
- Surgery: Removing endometrial lesions canhelp manage pain from the disease and it might boost your chances of gettingpregnant. But repeated surgeries can cause scar tissue to form on thereproductive organs, which could be problematic. Your Ob/Gyn can help you weighthe pros and cons of surgery.
- In-vitro fertilization: IVF may not be cheapor easy, but it is effective. Women with and without endometriosis have similarIVF success rates, as long as their ovaries are still capable of producingeggs, Dr. Attaran says. Since the egg and sperm are meeting in a petri dish,they have been removed from the inflammatory pelvic environment.
How Will Endometriosis Affect Your Pregnancy
Having endometriosis doesnt guarantee that youll have pregnancy complications. But complications are possible, so your doctor may recommend extra monitoring during your pregnancy.
A 2017 study of more than 19,000 births found that people with endometriosis had a higher risk of severe high blood pressure, hemorrhage, problems with the placenta, and premature broken waters.
The babies in the study had an increased risk of being born before 28 weeks gestation, small size for gestational age, congenital malformations, and death.
Having endometrial surgery before pregnancy also comes with increased risks. One study found that people who had surgery to treat endometriosis were more likely to have placenta previa, a condition in which the placenta blocks the cervix, making vaginal delivery risky and warranting a cesarean delivery.
According to a 2018 research review, endometriosis is also associated with higher risk of gestational diabetes, cesarean delivery, and neonatal intensive care unit admission for the baby.
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I Have No Pain And Im Trying To Get Pregnant
The puzzling part of endometriosis is that the degree of disease does not always correlate with the degree of pain that a patient experiences. Some women only have infertility as a consequence of endometriosis, and do not have any pain at all. For these women, the benefit of surgery is less clear, but fertility treatment can be very helpful. This could be either medication to stimulate the ovaries combined with an IUI or IVF.
To watch our On-Demand Webinar on Getting Pregnant with Endometriosis, . During this free, on-demand event, viewers will learn about the causes and symptoms of endometriosis, and the treatments that are now available to help women conceive. With proper counseling and care, the chances of getting pregnant with endometriosis are high for most women.
Editors Note: This post was originally published in March 2016 and has been updated for accuracy and comprehensiveness as of March 2018.
For more information about getting pregnant with endometriosis, or for more information about egg freezing to help preserve your family-building options for the future, please speak with one of our New Patient Liaisons at 1-877-971-7755 or click to schedule an appointment.
How Does Endometriosis Affect Pregnancy And My Baby
Most women with endometriosis will have a normal pregnancy. Extra monitoring is not recommended, but this is something to discuss with your doctor.
Your midwife or doctor will watch out for high blood pressure. There is a slightly higher than average risk that you will get some bleeding towards the end of your pregnancy.
There is also a chance your baby will be born earlier than usual or smaller than usual.
During pregnancy, endometriosis can improve but it often comes back later and may cause problems becoming pregnant again.
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Endometriosis And Its Effects On Fertility
Evidence suggests that about 20 to 30 percent of women with endometriosis experience difficulties with fertility. Another way of looking at it is that 70 to 80 percent of women with endometriosis will be able to conceive naturally.
Scientists dont fully understand the link between endometriosis and its effects on fertility.
Klebanoff says the impact endometriosis can have on fertility likely depends on where the endometriosis is. If the inflammation is occurring inside the pelvis, it can lead to scarring and scar tissue that can damage the fallopian tubes and make it difficult to conceive naturally. Inflammation in the pelvis can also make it harder for an embryo to successfully implant in the uterus.
Klebanoff advises his patients with suspected endometriosis who are trying to become pregnant to try to conceive for three or four months. If they still have trouble conceiving after that, he says its time to figure out if endometriosis may be interfering so that they can begin treatment. Ultimately, the further you delay treatment, the harder it becomes to conceive naturally.
The Physical And Emotional Pain Of Endometriosis
The symptoms of endometriosis can be debilitating, and if they go on long enough, your emotional health is certain to be affected. Symptoms include:
- Severe menstrual cramps
- Nausea
- Fertility problems
The longer you live with these symptoms, the more anxious and discouraged you might feel about whether youll be able to have a baby.
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What Are The Symptoms Of Endometriosis
Symptoms of endometriosis can include:
- Pain. This is the most common symptom. Women with endometriosis may have many different kinds of pain. These include:
- Very painful menstrual cramps. The pain may get worse over time.
- Chronic pain in the lower back and pelvis
- Pain during or after sex. This is usually described as a “deep” pain and is different from pain felt at the entrance to the vagina when penetration begins.
- Intestinal pain
- Painful bowel movements or pain when urinating during menstrual periods. In rare cases, you may also find blood in your stool or urine.
Can I Get Pregnant With Endometriosis
Endometriosis is one of the most common causes of female infertility, and it affects up to 10% of women of childbearing age, according to the National Institute of Health. As if the extreme chronic pain and heavy bleeding that endometriosis can cause were not enough, it can also seriously derail your plans to get pregnant. Of the more than 5 million American women coping with endometriosis, at least a third must also deal with its impact on their fertility.
If you have been diagnosed with endometriosis and are trying to get pregnant, what are your options? Getting a good understanding of endometriosis and its complications is a smart first step. Weve put together this guide to getting pregnant with endometriosis so that you can feel empowered to talk to your doctor about possible next steps.
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I Have Endometriosis Can I Ever Get Pregnant
The short answer is: absolutely.
Having endometriosis may seem painful, frightening, and hopeless, but the silver lining is the chances of a woman with endometriosis getting pregnant are very good.
What is endometriosis?
Endometriosis is a condition where endometrial tissue, which is normally inside the uterus, grows outside the uterus on the ovaries, pelvic cavity, and fallopian tubes.
What causes it?
There are several theories for what causes endometriosis because none of them can explain everything we see clinically. The most popular theory is retrograde menstruation. In this theory, some of the menstrual fluid exits the uterus out of the fallopian tubes into the pelvic cavity instead of all of the menstrual fluid exiting out of the vagina. The menstrual fluid that ends up in the pelvic cavity is then thought to be the seeds for the endometriosis implants. A second theory is coelomic metaplasia. For this theory, specific cells that cover much of the pelvic cavity just transform into endometrial cells for unknown reasons. It is then believed that those transformed cells act as the seeds for the endometriosis implants. A third theory is the spread of endometrial cells via the blood or lymphatic system. This theory may explain how endometrial cells can get outside the pelvic cavity into distance places such as the lungs.
How does it affect fertility?
So how can I get pregnant, then?
Are chances of IVF success good for women with endometriosis?
So what should I do now?
How To Get Pregnant When You Have Endometriosis
People with endometriosis can become pregnant and carry a healthy pregnancy to term. Endometriosis is a complex disease that can cause pain and infertility, but there are treatment options, and pregnancy is possible. Read on to learn more about endometriosis and infertility, including how endometriosis causes infertility.
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How To Improve Your Chances Of Conceiving With Endometriosis
Currently, theres no evidence that medication can improve a persons chances of getting pregnant with endometriosis. But doctors may prescribe medications, such as progestins, to increase the amount of pregnancy hormones in the body.
Its also important to live as healthy a lifestyle as possible when you have endometriosis and are trying to get pregnant. This can reduce inflammation in your body and prepare it to help your baby grow and thrive throughout a healthy pregnancy.
Examples of healthy steps include:
- maintaining a healthy-for-you weight
- eating nutrient-dense foods rich in fruits, vegetables, whole grains, and lean proteins
- engaging in moderate exercise on a daily basis
Keep in mind that age can be a factor for anyone wishing to get pregnant. Higher fertility rates are associated with younger age. Women ages 35 and older are at an increased risk for both fertility issues and miscarriage than younger women.
Women with endometriosis have potentially higher rates of:
- preterm delivery
What Happens To The Endometriosis Pain When Yoi Are Pregnant
Endometriosis | Your Fertility
Endometriosis is a condition where the tissue that lines the uterus also grows in other areas of the body
Read more on Your Fertility website
The Pink Elephants Support Network – Female Fertility Issues – Pink Elephants
The Pink Elephants Support Network are a not for profit charity, formed to support women through miscarriage, pregnancy loss and beyond.
Read more on Pink Elephants Support Network website
Raising Awareness Tool for Endometriosis
The Raising Awareness Tool for Endometriosis is a quick-to-use electronic resource for health professionals and their patients to help identify and assess endometriosis
Read more on RANZCOG – Royal Australian and New Zealand College of Obstetricians and Gynaecologists website
Endometriosis | Jean Hailes
Endometriosis is a condition that occurs when cells similar to those that line the uterus are found in other parts of the body.
Read more on Jean Hailes for Women’s Health website
Endometriosis – Better Health Channel
Read more on Better Health Channel website
Fertility tests
There are a number of tests that are available to determine your fertility.
Read more on Pregnancy, Birth & Baby website
Fertility treatments
There are a number of fertility treatments that are available to both and your partner if you are struggling to fall pregnant.
Read more on Pregnancy, Birth & Baby website
Fertility explained | VARTA
Read more on Victorian Assisted Reproductive Treatment Authority website
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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.
Chances Of Getting Pregnant With Endometriosis
Although endometriosis and infertility are connected, most women with endometriosis are still able to get pregnant. Nearly 70 percent of women with mild to moderate endometriosis are able to become pregnant without treatment.
For women with endometriosis who want to become pregnant , most doctors recommend seeing a fertility specialist early on. Since its easier to become pregnant in your 20s than in your 30s or 40s, consider talking with your doctor about your options well in advance.
Nearly 70 percent of women with mild to moderate endometriosis are able to become pregnant without treatment.
If youre in pain but not trying to get pregnant, your gynecologist can suggest non-hormonal or hormonal treatment options to manage the pain associated with endometriosis. Laparoscopic surgery is one of those options. Endometriosis surgery can make it possible for you to get pregnant. If youre considering a laparoscopic surgery, its important to know that this surgery has the potential to reduce the quality and quantity of your viable eggs, especially if there are endometriomas.
Egg freezing is an option for women with endometriosis who might want to start a family in the future. The number of eggs you produce decreases over time, and endometriosis often gets progressively worse. Because of this, freezing your eggs can be a good option for increasing your chances of becoming pregnant in the future.
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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.
1. NHS Choices Endometriosis
2. RCOG Endometriosis, Information for you. Royal College of Obstetricians and Gynaecologists. Review date 2019. London, UK
3. ASRM Revised American Society for Reproductive Medicine classification of endometriosis: 1996
4. American Society for Reproductive Medicine, Fertility and Sterility , Volume 67, Issue 5 , 817 – 821
4. NHS Choices Complications of endometriosis
5. NICE Endometriosis: diagnosis and management, Full Guidelines. Draft for Consultation. Version 1.0 Consultation. National Institute for Health and Care Excellence. London, UK
Review dates
Last reviewed:Next review:
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Understanding The Relationship Between Endometriosis And Fertility
The first thing you should know is that theres not a definite link between endometriosis and infertility. Some women who have endometriosis have no problem getting pregnant, while others do. Nationally, 30%-50% of women with endometriosis will face some infertility issues, but that means 50%-70% will have no problem at all. So be encouraged.
To understand why endometriosis might interfere with your pregnancy plans, you need to understand whats going on in your uterus. Immediately following conception, a fertilized egg implants itself in the lining of your uterus. But if you have endometriosis, the tissue that lines your uterus has grown outside of its assigned organ and can cause some problems.
That roaming endometrial tissue still acts like it did when confined to your uterus gradually getting thicker and trying to slough off like it does during your menstrual cycle but it has nowhere to go. This can eventually result in a buildup of scar tissue and may cause complications with reproduction if not treated.
An important takeaway here is that if you dont want to get pregnant, do not assume your endometriosis has made you infertile. Plenty of women with this condition have no problems getting pregnant. So practice safe birth control to avoid an unwanted pregnancy.
If you do want to become pregnant, here are the some of most common endometrial complications that could interfere with your efforts, and how our doctors at Womens Specialists of Fayette can help.
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Surgery And Fertility Rates
The number one reason for surgical removal of endometrial deposits is to reduce pain symptoms. This is sometimes done at the time of diagnosis. Beyond pain reduction, surgery may also offer added benefits in terms of increased fertility.
For women with severe endometriosis, surgery does appear to improve fertility treatment success rates. On the other hand, repeated surgeries can reverse those gains by causing the extensive formation of adhesions.
Some research also found small but significantly improved live birth rates after surgery for women with stage 2 or 3 endometriosis.
However, if a woman isnt experiencing endometrial pain, the risks of surgery outweigh the possible fertility benefits. Surgery to remove endometrial deposits has its risks, and you need to weigh the pros and cons of surgery to make a fully informed choice.
If youre still unsure after speaking with your healthcare provider, dont be afraid to seek a second opinion.
