Understanding Your Fertility Treatment Options For Endometriosis
Endometriosis can impair a woman’s fertility and present a host of additional complications, including pain and menstruation issues. By understanding what endometriosis is, you can take the first step toward figuring out the cause of your infertility and other symptoms. Here's what you need to know about endometriosis and infertility, as well as treatment approaches.
What is endometriosis?
The endometrium is a type of tissue that lines the inner part of your uterus. Sometimes, a similar type of tissue can grow outside of the uterus, such as the ovaries. This condition is known as endometriosis.
These growths are not cancerous. However, this excess layer of tissue continues to act as it normally would, but not in proper conjunction with the rest of the body. Whereas your regular uterine lining separates and bleeds out of the body during each menstrual cycle, these external tissues from endometriosis aren't released.
As a result, they stay and grow within the body. Cysts can also form in these areas, leading to scarring and other issues. The most common symptom is pelvic pain that worsens near menstruation, but it can lead to other possible complications and symptoms. Up to 6-10% of women suffer from this condition.
People with endometriosis may experience some or all of the following symptoms:
- Pain: One of the tell-tale symptoms of this condition, patients will likely experience pain along the pelvis, lower back, or abdomen, especially during their period
- Pain after sex: Patients may experience similar pains during or after sexual intercourse
- Excessive bleeding: Periods may be heavier than normal, and bleeding may even occur in between regular menstrual cycles
- Changes in bowel movements: You may suffer from constipation, painful bowel movements during menstruation, or diarrhea or nausea
- Heightened fatigue: Patients with this condition experience uncommon levels of fatigue
- Fertility challenges: Estimates vary, but up to 25-50% of infertile women have endometriosis, and 30-50% of women with endometriosis are infertile, as we'll discuss below
Note that up to 25% of patients with this condition are asymptomatic. You may only realize you have endometriosis after having challenges conceiving. If you experience these symptoms or are unable to conceive, speak with your doctor or one of our fertility experts.
For an endometriosis diagnosis, they'll use one or a combination of the following tests:
- Pelvic exam
- Transvaginal ultrasound
- Laparoscopy procedure
By visiting The Fertility Institute of New Orleans, you can gain insight into this issue and a definitive diagnosis. If you do in fact have endometriosis, our staff is prepared to help you through the appropriate endometriosis and infertility treatment process, such as with in vitro fertilization (IVF).
Can you get pregnant with endometriosis?
To start, many people with endometriosis are able to get pregnant. For those with mild or asymptomatic cases, managing your risk factors in other areas may improve your chances of conceiving. This includes quitting smoking and managing weight.
However, up to 50% of women with this disorder experience some level of infertility challenges. According to a study in the Journal of Assisted Reproduction and Genetics, infertile women "are 6 to 8 times more likely to have endometriosis than fertile women."
Those with more severe cases of endometriosis generally have more challenges getting pregnant. This is because endometriosis can result in:
- Distorted anatomy, such as a change in the shape of the pelvis or reproductive organs
- Pelvic inflammation
- Hormonal imbalances
- Decreased egg quality
- Impaired embryo implantation
- Abnormal uterine contractions
Once pregnant, patients with endometriosis also have a greater risk of miscarriage. A study from Human Reproduction found that preveious miscarriage rates were "significantly higher in women with endometriosis compared with the controls (139/478 [29%] versus 187/964 [19%], respectively; P < 0.001)."
There is hope, however. At the Fertility Institute, we've helped many patients with endometriosis and infertility issues get pregnant with a combination of therapies.
How to treat endometriosis
Treatment for endometriosis depends on a few factors, including:
- The severity of your condition
- Your overall symptoms and their impact on your quality of life
- Other various risks to your health, including comorbid conditions like PCOS
The next important step is assessing your pregnancy plans. This will dictate your treatment approach, both short- and long-term.
If you want to get pregnant in the future, but aren't ready to do so now, your doctor may prescribe hormonal birth control. These medications can help offset any hormonal imbalances and slow the growth of endometriotic tissue. They don't fully correct the disorder, but they're a non-invasive way to reduce growth, pain, and other symptoms while you consider more permanent options.
Getting pregnant with endometriosis
If you do want to conceive, and have had issues doing so, you and your doctor will decide on a treatment plan.
Your doctor may first suggest less invasive laparoscopic surgery to excise portions of the endometriotic tissue from around your uterus and ovaries. This is done to restore your pelvic anatomy and remove large cysts.
They may also suggest in vitro fertilization, or IVF, for endometriosis and infertility. IVF can raise your chances of a successful pregnancy, in spite of endometriosis. Through a combination of hormonal injections, manual fertilization, and transferring the embryo directly to the uterus, patients are given significantly increased odds of getting pregnant.
In fact, a study review in Obstetrics and Gynecology Clinics of North America found that: "IVF appears to be the most successful treatment option for patients with all stages of endometriosis."
Other endometriosis treatments
Unfortunately, as the Office on Women's Health notes, there is no cure for endometriosis. Treatments work to alleviate symptoms, help you conceive, or manage other complications. This may include long-term use of hormonal birth control, laparoscopic surgeries, and pain management.
If your symptoms aren't remedied by the above methods, and you're not trying to conceive, your doctor may suggest a hysterectomy as a last resort.
In this surgery, the uterus, cervix, and ovaries are removed completely from the body. This prevents the further growth of excess tissue, but it also prevents patients from ever becoming pregnant. Likewise, most symptoms of endometriosis improve after menopause.
Get help for endometriosis and infertility challenges
At The Fertility Institute, we want to help you solve your fertility problems. If you're suffering from endometriosis symptoms, contact us to schedule an initial consultation.
We welcome patients from all over, especially those in Louisiana and neighboring states.
Originally posted August 30, 2014.