Getting Pregnant After Endometriosis
Procedures can address your endometriosis, possibly reversing your reproductive problems.
In an operative laparoscopy for endometriosis, your New York Fertility Institute provider inserts a small instrument through your umbilicus, and uses small secondary incisions to remove endometriosis implants or reproductive system blockages.
If you have ovarian endometriomas, we use sclerotherapy, preserving your oocytes and protecting your future fertility.
Some patients still struggle to get pregnant after surgical treatment for endometriosis. In such cases, the New York Fertility Institute team can recommend other fertility medicine options and treatments, including ovarian stimulation and intrauterine insemination , or in vitro fertilization .
Get in touch with the New York Fertility Institutes Manhattan Upper East Side office in New York to learn more about your options for getting pregnant after endometriosis. You can schedule an appointment online, or call 212-772-8882 today.
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Hormonal Treatments And Surgery Are Both Options For Those Struggling With Endometriosis And Infertility
Medical interventions for endometriosis and infertility range from surgeries to in vitro fertilization or even a combination approach. Again, it depends on your specific circumstances and how extensive your endometriosis might be.
âI have been told by infertility specialists that removing endometriosis/adhesions may increase the chance of getting pregnant in the women that are having difficulty getting pregnant,âDr. John F. Dulemba, MD, FACOG, an endometriosis and pelvic pain specialist at The Womenâs Centre, told INSIDER. âThat is why surgery is so important. Hormonal treatments may not have a role in this aspect.â
If you and your healthcare providers decide that surgery is the best next step for you, there are still some things you might want to know.
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Treatments For Stages Iiiiv
In the later stages of endometriosis, a doctor will likely recommend IVF.
This treatment requires a person to inject fertility medication that promotes egg growth. Once a person has enough eggs, a doctor harvests them. After selecting the best eggs, they fertilize each with sperm to create embryos.
The doctor then implants embryos into the uterus.
Endometriosis is a painful, progressive condition that can be difficult to cope with. People struggling to get pregnant with the condition may feel isolated and discouraged, especially if they have been trying for a number of years without success.
If someone needs additional resources, be it support groups or advice, they can try:
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What Are The Dangers Of Being Pregnant With Endometriosis
Several studies have indicated that endometriosis is a risk factor for complications during pregnancy. Your doctor should advise you on the potential risks associated according to the severity of your endometriosis.
The risks associated with pregnancy in women with endometriosis include increased risk of miscarriage, ectopic pregnancy, placenta displacement, spontaneous rupture of the uterus, obstructed labor, postpartum hemorrhage, and preterm birth.
What Are Your Reproductive Options If You Have Stage Iv Endometriosis
Endometriosis affects 10-15% of all women. Of women with endometriosis, 30-50% are estimated to have infertility of women with infertility, 25-50% are estimated to have severe endometriosis. A hallmark of endometriosis is inflammation and subsequent formation of adhesions in the pelvis. These adhesions distort the pelvic anatomy and impacts the woman in a variety of ways. The most direct consequence of adhesions can be a disruption of the anatomical relationship between the ovaries and fallopian tubes. In advanced cases of endometriosis, tubal blockage may occur to the point of a hydrosalpinx which may require removal before any fertility treatment.
The most appropriate treatment for each couple will depend on a number of factors including the womanâs age, the duration of infertility, her ovarian reserve, the sperm analysis, a history of past surgery for endometriosis and its severity.For women younger 35 years of age with low stage disease, a trial of Fertility treatment with intrauterine insemination is recommended. However, for women greater than or equal to 35 years of age with advanced stages of endometriosis , IVF is recommended due to the higher pregnancy rate. Of note, advanced endometriosis, compared to other diagnoses, may reduce the pregnancy rate with in vitro fertilization.
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How Can I Tell If I Have Endometriosis
Many women with endometriosis have pelvic or abdominal pain, particularly with their menstrual bleeding or with sex. Some women have no symptoms. Endometriosis can make it difficult to become pregnant. In fact, 30% to 50% of infertile women have endometriosis. Sometimes, endometriosis can grow inside your ovary and form a cyst . This usually can be seen on ultrasound, unlike other endometriotic tissue. The only way to tell for certain if you have endometriosis is through a surgical procedure called laparoscopy.
Can You Get Pregnant When You Have Endometriosis
Many women worry that endometriosis will affect their chances of getting pregnant.
While it doesnt mean you will struggle with conceiving, theres a chance it may cause complications .
What does endometriosis mean for you and your fertility? What options are available to you if you struggle to conceive naturally?
Below, we answer five pertinent questions you may have regarding endometriosis and fertility, including fertility treatment options like traditional IVF and using donated eggs.
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Will Endometriosis Affect My Pregnancy
Whether you conceive naturally, through IVF, or use donor egg, you may worry if endometriosis will affect your pregnancy. However, most endometriosis sufferers enjoy happy and healthy pregnancies.
Some do note more pain than others at the start of pregnancy, but this should ease. Its also important to note that pain from endometriosis can return after youve given birth as well.
Surgical Treatment Of Endometriosis And Fertility
Women with Stage I and II endometriosis may become pregnant on their own, however, medical studies do suggest that if laparoscopy is done in women who have infertility, they are more likely to have endometriosis than women who become pregnant with no difficulty. There is some evidence that pregnancy rates may improve if Stage I or II endometriosis is removed surgically, however some data shows that this does not help.
In general, when women are young it is reasonable to remove any visible endometriosis to see if pregnancy occurs. If women are 35 or older, other fertility treatments are recommended instead of laparoscopy . If Stage III or IV endometriosis is present, pregnancy rates are higher after surgery is performed to remove scar tissue or large endometriotic cysts. If pregnancy does not occur within 6 months after surgical treatment of endometriosis, other fertility treatments should be discussed.
Unfortunately, some women with endometriosis can have cysts that come back. If cysts are removed over and over, this can cause a loss of eggs from the ovaries, and can make it harder to become pregnant.
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When Pcos May Challenge Your Ability To Be Pregnant
Women with PCOS may have trouble conceiving because excess circulating hormones can inhibit ovulation. Women with PCOS also typically have insulin resistance and higher levels of insulin-like growth factor that promote androgen production, compounding the problem, by leading to weight gain and type 2 diabetes. This constellation of symptoms places women with polycystic ovary syndrome at higher risk for gestational diabetes.
While it is well known that excess weight can exacerbate the symptoms of PCOS and the hormonal imbalances driving PCOS can promote weight gain, no one knows for sure which comes first. Experts have recently termed this conundrummetabolic inflexibility.6
One thing is certain, if you have PCOS, achieving weight lossalbeit easier said than donerepresents one of the best solutions available to increase your prospects for fertility. In a recent National Institutes of Health-funded study, women who achieved modest weight loss with a change in diet and addition of exercise improved their rates of fertility substantially.6 Dr. Richard-David agrees, and suggests that her patients aim to lose just ten percent of their current body weight, which is enough to significantly increase your chances of conceiving, and improving your pregnancy outcome and that of your baby even losing just two percent of your body weight will help.
Can Endometriosis Cause Ectopic Pregnancy
More research is needed, but research suggests a link between endo and ectopic pregnancy.
4. Fact: Women with endometriosis could have an increased risk of ectopic pregnancy.
A meta-analysis of 15 studies in the February 2020 issue of the Journal of Minimally Invasive Gynecology concluded that women with endometriosis have a 2.66 higher risk of having an ectopic pregnancy a pregnancy that occurs outside the uterus, usually in the fallopian tube compared with women who dont have the disease. The previously mentioned study in the September 2019 issue of Obstetrics and Gynecology found that endometriosis was associated with a 46 percent increased risk of ectopic pregnancy.
This elevated risk may be because endometriosis can affect the fallopian tubes. We know that fallopian tube damage definitely increases the risk of ectopic pregnancy, so its biologically reasonable to assume that if endometriosis is present involving the tube, ectopic pregnancy may be a higher risk, Dr. Woodall says.
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Staging And Infertility Risk
During the diagnosis of endometriosis, your doctor may refer to the stage of the disease. Staging is a way to describe the severity of your condition based on the location, amount, and depth of tissue overgrowth. The stages of endometriosis run from stage 1 for the mildest form of the disease to stage 4 for the most severe form.
As a general rule, women with stage 1 or 2 are more likely to conceive than women with stage 3 or 4. But that’s not always true.
In some cases, women with stage 1 may have more trouble getting pregnant than someone with stage 3 or 4. The risk depends largely on which organs of the female reproductive system are affected and how.
Where staging does help is with planning. For example, a woman with stage 1 or 2 endometriosis may try to conceive on her own at first, while someone with stage 3 or 4 may proceed directly to fertility treatment.
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.
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Let’s Start With The Basics: What Is Endometriosis
It’s a condition that causes tissue commonly present in the lining of the womb to grow in other places – such as the ovaries or fallopian tubes. Each month, these cells react in the same way as those in the womb building up and breaking down and bleeding, but the blood has no place to go. This commonly causes inflammation and pain in your pelvic region, lower back, or stomach that intensifies during your periods.
Speaking of periods… women with endometriosis often have heavy and irregular flows. Now, we all experience some form of PMS but the pain associated with endometriosis is often strong enough to stop you from completing your normal daily activities, and can worsen when having sex, urinating, and during bowel movements.
How To Get Pregnant With Endometriosis
If you have endometriosis and are interested in starting a family, it may help to speak with your endometriosis specialist or OB-GYN first. This is particularly true for women who have had multiple surgeries for endometriosis.
“Women with endometriosis who are trying to conceive should see a reproductive endocrinologist,” says Witt. “A fertility specialist can evaluate the woman’s individual case based on her symptoms, ultrasound findings, age, and other fertility factors in order to determine the best course of treatment.”
A reproductive endocrinologist can also conduct blood tests, such as an anti-mullerian hormone test. This test can help determine a patient’s remaining egg supply or ovarian reserve.
Endometriosis isn’t a one-size-fits-all condition, but taking the time to speak with your doctor, limiting your intake of inflammatory foods, and engaging in moderate physical activity can improve your chances of natural conception.
If after six months you and your partner are unsuccessful conceiving naturally, you may want to consider an endometriosis-related infertility treatment option, like the ones listed below.
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Get Pregnant With Endometriosis
Endometriosis is a medical condition where the tissues that line the uterus on the inside tend to grow outside. It affects 1 in 10 women, plays a huge role in fertility, and usually gets misdiagnosed.
Though the tissue has been displaced, it continues to act normally such as it thickens, then breaks down and with every menstrual cycle, it bleeds. However, because it is displaced, it gets trapped as it cannot get out of the body. The tissue surrounding the endometrial tissue becomes irritated thereby leading to scarred tissue or adhesion. All this causes pain and may increase in severity during periods.
Nearly to ½ of women with Endometriosis experience difficulty conceiving.
In honor of Endometriosis Awareness Month, on this episode of Tips and Tea with Your Fertility Godmother, I was live sharing 5 things to help you get pregnant with Endometriosis.
Treating endometriosis begins with your symptoms and goals. Some women want to manage their pain while others want to get pregnant. The treatments for women who plan to have a baby may be different from those whose chief complaint is the pain.
You do not have to accept pain or infertility because of endometriosis. Many women with endometriosis believe they have no choice but to live with its symptoms or seek surgery. Holistic therapies have proven effective in managing the symptoms of endometriosis while increasing fertility.
How Can Endometriosis Be Treated
Often, drug treatments arent successful for endometriosis sufferers but surgery to help remove cysts or scar tissue may be beneficial. The treatment route offered by your doctor will depend upon several factors, including your age, symptoms, and how soon you want to get pregnant.
Sometimes, endometriosis improves on its own. All you may need are over-the-counter painkillers and birth control pills to help manage your symptoms.
In other cases, it can become much worse. Regardless of your personal situation, your doctor will want to monitor your symptoms in case the condition escalates.
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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.
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 .
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. Its hard to know which group youll 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 youre 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 youre 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.
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How Do You Get Pregnant Naturally With Endometriosis
Even though endometriosis may affect your chances of getting pregnant, most women with mild endometriosis are not infertile. For some people with endometriosis, surgery may increase the chances of pregnancy. However, for others with more severe disease who do not get pregnant after six to 12 months, IVF is recommended.
Ectopic Pregnancy And Endometriosis
Mr Tsepov says, Presence of endometriosis increases the risk of ectopic pregnancy and risk of early miscarriage and can complicate pregnancy during later stages.
An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, often in the fallopian tubes. These tubes connect the ovaries to the womb. So when an egg gets stuck in them, it cant develop into a baby.
According to data analysed and presented by ESHRE European Society of Human Reproduction and Embryology, the risk of an ectopic pregnancy is increased from 0.6% normally to 1.6% with endometriosis, he says.
The risk of ectopic pregnancy is relatively low in the general population, with 1 in 90 pregnancies in the UK becoming ectopic. However, as consultant gynaecologist and laparoscopic surgeon, Mr Tsepov, says, this risk is more than doubled in women who have been diagnosed with endometriosis. This is because the condition can produce tissue and even adhesions. These interfere with the journey of the fertilised egg to the uterus.
Unfortunately, the NHS says, its not possible to save a pregnancy thats ectopic. Doctors use medicine or an operation to remove it.
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