You should feel fortunate to have a confirmed diagnosis of endometriosis, which otherwise takes on an average 7 years to diagnose, for the reasons already discussed in our earlier blog. In many cases, the severity of the ailment progresses to a point where it affects the ability to conceive. So Endometriosis related infertility is a real fact and in this blog, we will explore why this happens and how to get around it for a successful pregnancy that will result in a healthy baby.
Patient-related silence is the major hurdle that delays the diagnosis of endometriosis along with other factors which we have addressed earlier.
Let’s address these factors one by one.
How does endometriosis affect fertility?
Endometriosis doesn’t cause infertility directly but it creates some hurdles in attachment due to inflammation of the fallopian tubes. In severe cases, having sex is very painful, so it may create an obstacle to pregnancy.
If you have a few spots of endometrial growth, still you will be able to preserve your fertility with a little assistance from your gynaecologist.
That’s why it is wrong to conclude that having endometriosis means you will not get pregnant.
It is indeed true that you may need additional assistance from experts. If, however, pregnancy is not achieved within 6-7 months of trying actively, one should see a fertility expert if you have already been diagnosed with Endometriosis.
There are many treatment options available to achieve pregnancy while suffering from endometriosis. The first thing is to observe the health of fallopian tubes and blockages if any. There are situations, irrespective of endometriosis, fallopian tubes are open and still, patients struggle for fertility.
The fertility expert will study the extent of the spread of endometriosis and the reproductive health of the woman, study the health records and suggest an age-specific programme to achieve pregnancy.
Does age have any impact on the endometriosis fertility journey?
Age is the main deciding factor in fertility preservation as well as pregnancy. Females are born with all the eggs they could probably have for a lifetime. We all know, that as age increases, the quality and quantity of eggs decrease even in normal cases. Endometriosis too is a hormone-driven condition, which further puts the burden on reproductive health. For those with endometriosis, and assisted reproductive technologies, couples do realise the dream of parenthood. It is often advisable to seek a fertility expert opinion within 6 months of active sex life.
Will surgery fulfil my dream of motherhood?
For those patients with superficial endometriosis, research shows laparoscopic surgery offer, better pregnancy rates and improves the chances of pregnancy naturally if you have had problems conceiving in the past.
Another scenario is when patients suffer from deep endometriosis (where the bowel, bladder or ureter is involved) there is no research done to confirm the same.
Will I still suffer from Pelvic chronic pain attacks during pregnancy?
It is often observed that the pain intensity reduces during pregnancy, but returns after delivery. There are reported chances of chronic pain in the first few months of pregnancy.
Does endometriosis cause miscarriage?
Sadly irrespective of any pregnancy, the percentage of miscarriage is 1 in 5 patients. In the case of endometriosis, the ratio is 1 in 4 patients. As there are lesions, adhesions and swelling in the tubes, which makes the implantation a bit risky & may result in miscarriage.,
Does endometriosis affect the quality of eggs?
Yes, there is evidence which could co-relate endometriosis with poor egg quality. One reason may be due to the high level of macrophages & cytokines. Macrophages are substances, some sort of cells that digest foreign particles or debris. The cytokines are the agents which cause inflammation in the reproductive tract.
When there is an increased amount of such toxic substances, egg-formed will be of a defective quality which may result in poor implantation rates and higher rates of spontaneous abortions.
The ovaries produce some hormones like progesterone and estrogen for reproduction purposes. These hormones are important to the maturation of an egg. Some experts believe that hormonal imbalances in the ovary, which may be due to Endometriomas, can affect egg development and egg quality.
Such hormonal imbalance in the case of endometriosis not only produces poor egg quality but also reduces egg count. Reduced blood flow due to scar tissues to & within the ovaries affects the egg maturation, so may not properly fertilize, implant & develop properly.
What, if I want pregnancy in future while fighting endometriosis?
Your struggle with Endometriosis is making you more vigilant, so it’s natural to think wisely about pregnancy in future. Considering the strong connection between endometriosis with egg quality & quantity, it is advisable to opt for egg freezing for future pregnancy. It is often the 1st wise step to think about fertility preservation in this way.
Endometriosis is a mystery for gynaecologists which requires equal participation with patients for decision-making with every step. We are happy to spread positive vibes for every endo warrior with our expertise in this domain. The EndometrioCEASE Clinic under the able guidance of Dr Chaitanya Ganapule, Laparoscopic and Hysteroscopic surgeon of repute at Pearl women’s Hosp & Yash IVF AT DECCAN, Pune is a landmark in itself.
The Endometrioses CEASE team is competent to tackle the challenges of Endometriosis. We have modern, updated protocols & infrastructure in place. Dr. Ganapule has impressive professional affiliations like a diploma in Pelvic Endoscopy from Kiel University, Germany, & Diploma in Gynac Endoscopy from France. He attended the Workshop of, the Franco-European Multidisciplinary Endometriosis Institute in France, in 2022.
This journey has formed his vision. His vision is, to offer endometriosis relief under one roof, at affordable cost, with financial assistance, which is the strong pillar of the Endometrioses CEASE arm.