Endometriosis is a disorder in which the endometrium, a tissue that forms the uterus lining, starts to develop outside the uterus. According to stats, 1 in 10 women develop endometriosis during their childbearing age. (1)
Around 10% to 20% of women (age ranging from 25 to 40 years) in the USA have endometriosis. (2)

Endometriosis has many physical and emotional consequences on women. It is one of the most common causes of dyspareunia in women. Besides, many women with endometriosis worry that the disease may cause difficulty in getting pregnant. This article has thoroughly explained the link between endometriosis and fertility to answer this common query.

What is endometriosis?

It is a chronic illness in which endometrium tissue starts growing outside the uterus. It affects areas like fallopian tubes, ovaries, and tissue that line your pelvis. Endometrium issue bleeds as your normal uterine tissue does during periods, but in this case, blood has no place to go to.

Due to this reason, the areas around this abnormal endometrium become swollen and inflamed. Its common symptoms include abnormal menstrual flow, excessive menstrual cramps, and pain during intercourse, etc.

Stages of endometriosis

Endometriosis is divided into four basic stages.

  • Stage I (minimal): Few implants of endometriosis develop and no scar tissue (a collection of cells).
  • Stage II (mild): More specs of endometriosis and no scar tissue.
  • Stage III (moderate): A bit more implants of endometriosis, development of endometriotic cysts, and a few scar tissues.
  • Stage IV (severe): Several implants of endometriosis, development of large endometriotic cysts, and several scar tissues in different parts.

Endometriosis and fertility

Endometriosis has a direct effect on fertility. The exact connection between this disease and the ability to get pregnant has not been well understood, but the disease complexity seems to affect fertility. Around 70% of women with minimal to moderate endometriosis can conceive naturally. (3)
If you have mild to moderate endometriosis and are still failing to get pregnant, talk to your doctor to find the right reason.

Severe endometriosis can have a direct impact on your fertility as it can change anatomy. It can distort the orientation of your pelvic anatomy. Change in anatomy can disturb the release of the egg during ovulation and sperm movement. However, many women with severe endometriosis can get pregnant naturally, but it may get harder for them to conceive. If you face such problems, then reach out to a doctor. Your doctor will recommend a treatment option according to your health condition.

Treatment options for endometriosis to improve fertility

Endometriosis has no cure, but there are different treatment options (medications, hormonal, and surgical treatments) to help a woman with endometriosis become pregnant. The common treatments that doctors use to help you manage endometriosis and improve fertility are:

Hormonal treatment

Many hormonal treatments are available for endometriosis. These treatments can cause symptoms like menopause and reduce your chances of getting pregnant; therefore, doctors avoid them when you are trying to conceive.

Surgery

Women with mild to moderate endometriosis can improve their fertility with the common surgery options. If you fail to conceive due to endometriosis, your doctor will discuss these treatment options with you.

Laparoscopy

It is the first surgical option that doctors recommend. Laparoscopy is also called keyhole surgery. During this surgery, your doctor gives you general anesthesia so you do not feel any pain. They will make a cut in your abdomen, most probably in your belly button. A tube that has a camera at one end (the end that is inserted inside the body) will be inserted through this cut. Doctors may make cuts on your bikini line too.

Then the doctor will use heat, laser, or scissors to remove endometrium tissue. This treatment is very effective but is not 100% successful. Some endometrium tissues can be left behind, or they can develop again.

Laparotomy

This surgical treatment is used only in exceptional cases. In laparotomy, wider cuts are made on the abdomen and bikini line. Then endometrium tissue is removed from the affected surfaces or parts. Again, endometriosis can grow back even after this surgical treatment. The chances of recurrence after five years are 50%.

Treatment options for infertility associated with endometriosis

If your doctor believes that the cause behind your infertility is endometriosis, he will start with light treatments like medications, injections, etc. If these treatments fail to induce pregnancy, then he will move to the following treatments.

Intrauterine insemination (IUI)

Your doctor will first give your fertility medications for five to six days. You will take them after your periods start. Your male partner will masturbate to release sperms in a sterile plate. They will send the plate to the fertility lab, where sperms will be processed.

You will visit the lab when you are near to releasing oocytes. Your partner’s sperm will be placed inside your uterus with the help of a thin tube. The chances of getting pregnant with this treatment are 10% for women who are under 40.

In-vitro fertilization (IVF)

In this treatment, your doctor will give you a fertility medication injection. This medication will cause the growth of eggs in the follicles (fluid pockets). Follicles are examined through ultrasound. When they reach a particular size, they remove the eggs. During the egg removal process, your doctor will first give you anesthesia. Then he uses a needle to remove eggs from ovaries.

They put your eggs on the plate that has sperms of your partner and start fertilizing to form embryos. After a few days, you will revisit the fertility lab. The doctor will place the fertilized eggs back in your ovaries. The chances of getting pregnant are more than 50% for women in their 20s. On the other hand, women in their 40s have a 10% chance of getting pregnant with IVF.

Can endometriosis affect pregnancy?

Endometriosis can cause pregnancy complications, but such cases are very rare. There is a chance of the development of placenta previa, which can cause severe bleeding during labor.

Final Thoughts
Endometriosis does affect fertility, but women with endometriosis still have a high chance of getting pregnant. If you fail to conceive due to this chronic condition, you should talk to your doctor for a better treatment plan.

References

  1. Facts about endometriosis (Endometriosis.org)
  2. Endometriosis | Johns Hopkins Medicine
  3. Endometriosis, fertility, and pregnancy | Endometriosis UK (endometriosis-uk.org)
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About the Author

Hermione M.

My name is Hermione. I am the founder of WomenH and I write about women's health, wellness, mental health, and personal growth. I created this platform to inspire women to take care of themselves mentally, physically, and emotionally to become their best selves. Thank you for stopping by.

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