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.
What Do Endometriosis Types And Stages Mean For Fertility
There are several different classification systems for endometriosis. The one from the American Society for Reproductive Medicine is widely used: It includes four stages of endometriosis, based on the location, extent, and depth of the endometriosis implants, the presence and severity of adhesions , and the presence and severity of endometriomas . While stage 1 involves few superficial implants and mild adhesions, stage 4 is characterized by deep endometriosis implants, large endometriomas, and many dense adhesions.
Getting Pregnant With Endometriosis
Julianne Houghs recent press about her struggle with endometriosis brings this common condition to the spotlight. So, lets say you have endometriosis, now what should you do and what are the treatment options for getting pregnant with endometriosis?
There are several factors that help us to make decisions about your treatment. Whether or not you have pain and whether or not you are trying toconceive are important questions that guide your treatment options, and which type of doctor might be best for you. Getting pregnant with endometriosis is very possible for most women. While endometriosis may make it harder to conceive on your own, your chances of getting pregnant with endometriosis can be high, depending on the severity of your condition, your age, your overall health, and your treatment options.
Since endometriosis can take many forms, and the success rates of treatments vary, your doctor will outline your best treatment options with an individual plan for you.
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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.
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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Can I Still Get Pregnant If I Have Endometriosis
Can you get pregnant even if you have endometriosis? Yes, but it depends on several factors.
If youve been diagnosed with endometriosis, it doesnt necessarily mean you cant have kids but it might mean you have to try a little harder.
Our experts at The Womens Specialists of Fayette are committed to helping women achieve optimal health and wellness, which includes helping them overcome the aspects of endometriosis that might complicate or prevent fertility.
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.
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Endometriosis May Put You At Higher Risk For Miscarriage
Statistics show that one in four pregnancies will end in miscarriage, but I was still shocked when it happened to us. It felt particularly painful after battling infertility.
In cases of severe pelvic adhesions, endometriosis may compromise the growth of the uterus, as well as blood flow to the endometrium, increasing miscarriage risk, Talebian shared, adding that endometriosis in some women may prematurely age their eggs and increase the risk of chromosomal abnormalities and therefore miscarriage. However, it is difficult to actually prove the endometriosis as the specific cause of miscarriage. If a miscarriage occurs and the pregnancy tissue shows abnormal chromosomes, we can not assume the woman has endo. Chromosomal abnormalities in the egg can be random and are more common in women over 35.
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.
“I 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,” Dr. John F. Dulemba, MD, FACOG, an endometriosis and pelvic pain specialist at The Women’s Centre, told INSIDER. “That is why surgery is so important. Hormonal treatments may not have a role in this aspect.”
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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Make Sure To Talk To Your Doctor About What Kind Of Surgery Is Best For You Before Undergoing Any Procedures
“If surgery is required, the surgeon should have advanced surgical training in minimally-invasive techniques, and should have the support from other surgical teams in the event of a complication of surgery,” Levine said.
Beyond ensuring that the surgeon is a specialist, you’ll probably want to know more about the details of the procedure and techniques that will be used, themselves.
“In our center, for example, we utilize the C02 laser as a cutting tool, whereas others may use it to vaporize those very delicate tissues. This is neither a realistic nor effective long-term approach to the disease, as vaporization leaves endometriosis behind and damages the tissue,” Guidone said. “By contrast, use of C02 laser energy in an excisional manner allows for precise, gold-standard surgical treatment, which removes endometriosis and preserves healthy tissue and organs, thereby restoring or preserving fertility a great deal of the time.”
Working with expert healthcare providers to address your endometriosis is important at all stages of your life, even if you’re not trying to conceive. Some of the condition’s other symptoms can be just as necessary to address.
“More women suffer from the pain of endometriosis and adhesions than have a difficult time getting pregnant, but both aspects interfere with women’s lives on a daily basis around the world,” Dulemba said. “This disease is so under recognized.”
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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 youre 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 cant get pregnant while youre taking these medications, they may help relieve symptoms and protect your reproductive organs from distortions that could lead to fertility problems later.
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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.
Endometriosis May Cause Infertility But Pregnancy Is Possible
While 30 to 50% of women with endometriosis experience infertility, natural conception with endometriosis is possible.
“Many women with endometriosis can successfully conceive with their own eggs and carry healthy pregnancies to term,” Talebian said.
Dr. Brian Levine, founding partner and practice director of CCRM-NY, agreed.
“Given its prevalence in the population, many people are likely conceiving and having healthy pregnancies without knowing their diagnosis,” he shared with TODAY. “Given that the frequency of diagnostic surgeries for infertility are decreasing, far fewer patients are being diagnosed with endometriosis and are likely undergoing IVF for unexplained infertility, when endometriosis is likely the causative agent.”
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Autoimmune Diseases May Confound The Prospect Of Pregnancy
Women with diabetes or other metabolic disorders are at increased risk of having other conditions that will likely add another layer of complexity to pregnancy, endometriosis, and PCOS. As if having PCOS or endometriosis isnt enough of a challenge, women who have thyroid disorders may face an even more complicated path to pregnancy. Women who have hypothyroidism may find the effort to lose excess weight more difficult, and even subclinical hypothyroidism can interfere with ovulation.9
In exploring the reasons behind your infertility, the experts recommend that you have your thyroid hormone levels checked if you havent already had your blood work done. Its important to work with your doctor to achieve a healthy thyroid function before attempting pregnancy.
Autoimmune disorders like systemic lupus can cause complications for women with endometriosis. Women who are under treatment for lupus usually receive steroids and immunosuppressant agents, which can worsen endometriosis symptoms by reducing the bodys ability to fight the growth of excess endometrial tissue. If you have these or other confounding conditions, youll be in good hand if you work with a team of specialists who can guide you to make decisions that are safest and most sensible for your health and pregnancy goals.
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 womans immune system to attack an embryo instead of trying to protect it.
Theres 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.
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If Youve Already Been Diagnosed With Endo
Generally, doctors dont diagnose or treat infertility until youve been trying to get pregnant for 6 months to a year. But if you know you have endometriosis, talking with your doctor and a fertility specialist can help.
When youre ready to start trying, hit up your medical team so they can help you come up with a game plan.
If youre taking medication to treat endometriosis , they likely prevent ovulation. Youll want to talk with your doc about how your meds affect fertility and whether you should stop taking them if youd like to get pregnant.
Having a known complication like endometriosis means its important to partner with your medical team to get the best outcome. Theyll help you develop a plan for trying to conceive, which could involve surgery and fertility treatments.
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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What Should You Ask Your Doctor About Endometriosis And Pregnancy
You can talk to your doctor about your condition and the best plan to get pregnant. Since that may look different depending on how severe your condition is, its most appropriate to seek your doctors advice. You may want to ask if surgery is suitable for you because it can increase your chances of getting pregnant.
Can You Get Pregnant With Endometriosis
Endometriosis is a complex medical condition that can, unfortunately, make it more difficult for some women with the disease to get pregnant. Somewhere from 30 to 50 percent of women with endometriosis experience infertility. The amount of endometriosis tissue seen on laparoscopy is directly linked to your future fertility as a patient with endometriosis.
However, just because endometriosis makes it more difficult to get pregnant does not mean it is impossible. Nearly ¾ of women with mild-to-moderate endometriosis go on to conceive within three years without the help of IVF. This means that while the process of getting pregnant may take longer for endometriosis patients, it is still usually possible to conceive naturally with the condition.
More extensive endometriosis can lead to the development of scar tissue or adhesions on the reproductive organs. It is thought that the presence of adhesions contributes to infertility in endometriosis patients. Thus, women with more severe endometriosis may require fertility treatment to get pregnant. This can include laparoscopic excision surgery to remove the endometrial-like tissue from the reproductive organs and/or IVF.
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Get An Early Ultrasound Scan
Additionally, women with endometriosis who become pregnant can benefit from an early ultrasound scan and early antenatal care with increased level of foetal wellbeing monitoring during all three trimesters of their pregnancy, Mr Tsepov says.
These patients are best looked after in high risk antenatal clinics by experienced obstetric consultants and midwives. The decision where to deliver the baby either on a midwifery led unit or on high-risk delivery suite should be discussed individually with an obstetric consultant with risks balanced versus benefits.
