About 11 percent of American women of reproductive age suffer from endometriosis, a painful condition that causes the tissue of the uterine lining (the endometrium) to grow outside the uterus. These growths are referred to as implants. Worldwide, about 176 million women have the condition. March is Endometriosis Awareness Month, which makes it a great time to learn about the disease and the effect it can have on a woman’s health and reproduction.
Endometriosis, fertility, and pregnancy
If you have endometriosis, one of your primary concerns is probably whether the disease will affect your ability to get pregnant and to carry a pregnancy to term, and unfortunately, your concerns are well founded. According to the American College of Obstetrics and Gynecology, endometriosis is one of the leading causes of female infertility, and as many as 50 percent of women who have endometriosis will also have trouble conceiving as a result of their disease.
Endometriosis can affect fertility in several ways. The endometrial tissue responds to fluctuations in your levels of estrogen. That means the implants that are growing outside of your uterus will still swell, bleed and attempt to shed during menstruation, just like your uterine lining. But because the implant tissue has nowhere to go when it sheds, the tissue around the implants can become irritated and inflamed, causing the painful symptoms characteristic of the disease.
As the tissue swells and breaks down every month, it can begin to cause scarring or adhesions. In severe cases, these adhesions can cause your tissues to stick together, interfering with the way the tissues and organs normally function and causing additional pain. When adhesions form inside or around the fallopian tubes (the tubes that carry the egg from your ovary to your uterus), it can prevent eggs from descending into the uterus, which means they can’t be fertilized. Some women with severe endometriosis form permanent scars inside the fallopian tubes, preventing them from ever becoming pregnant.
In addition to the problems associated with scarring, the inflammation caused by endometriosis can also interfere with your ability to conceive. Inflammation causes major changes in the environment inside your uterus, making it inhospitable to both sperm and eggs. That means that even if your egg does make it to the uterus, the inflammation caused by endometriosis can wind up damaging or destroying the egg or the sperm before fertilization can occur.
What if you’re already pregnant? Well, then there’s some good news. The hormonal changes associated with pregnancy can actually help decrease the symptoms of endometriosis. That means once you do manage to conceive, implant growth slows significantly or may stop altogether. Of course, if you have endometriosis, you’ll still need to be monitored closely during your pregnancy to ensure complications don’t occur.
Improving fertility with endometriosis treatment
If you have endometriosis and you’re having trouble getting pregnant, the first step is to determine if endometrial implants or adhesions are the cause of your infertility or if other issues may be preventing pregnancy (or at least paying a role in your infertility). When endometriosis is determined to be the cause, most women will need to have a minimally invasive surgical procedure to remove the adhesions and implants that are interfering with conception. The procedure uses very small incisions in your belly, along with a special scope that’s equipped with a very tiny camera. The camera takes videos that are transmitted back to a monitor, allowing your doctor to evaluate your implants and remove adhesions and growths without using a large incision. Because the implants can regrow, you’ll have the best chance of conceiving during the several weeks that follow your procedure.
Endometriosis can also be treated or controlled with hormone medications like birth control pills or with IUDs that use hormones. In some cases, when instituted early enough, these methods may prevent inflammation and scarring, as well as reduce the painful symptoms caused by endometriosis. If you’re planning to become pregnant, it’s important to schedule an office visit as soon as possible so you can receive treatment that can help you conceive when you’re ready.
Learn more about endometriosis treatment
At Brown, Pearson, and Guepet Gynecology, we offer the most advanced treatment options for endometriosis to help women find relief from painful symptoms and improve their chances of getting pregnant. To find out more about endometriosis treatment or to schedule a consultation, contact the practice today.