Getting pregnant with endometriosis can be more challenging than expected, yet around 7 of every 10 women with mild to moderate endometriosis conceive without any treatment. Many aren’t aware of endometriosis, and if they do, they aren’t familiar with the treatment options. Today’s article will help you understand Endometriosis and how to treat it effectively.
1. What is Endometriosis and Symptoms of Endometriosis
Endometriosis is a reproductive disorder wherein little bits of tissue that form the endometrium lining of the uterus develops outside; for example, on the bowel or bladder, ovaries and fallopian tubes and on the lining of the abdomen.
Women of childbearing age are mostly affected by endometriosis. Symptoms of endometriosis can vary, but the most common symptoms include:
- Painful, heavy or irregular periods
- Pain in the lower abdomen, pelvis or lower back around ovulation time, but also during the entire the cycle
- Continuous pelvic pain lasting half-a-year or longer
- Pain during or after sex
- Trouble conceiving
- Painful bowel movements and emptying of the bladder
A few women have also complained about:
- Bleeding from the anus
- Painful stomach scars or pain around the belly button, particularly during the menstrual period.
- Coughing blood (exceptionally rare)
Although some women probably won’t acknowledge they have endometriosis until they are diagnosed or experience issues with conception, others are in continuous pain all through their lives and have continuous rounds of medical procedures to deal with the condition.
2. What Causes Endometriosis?
According to studies, 30% to 45% of infertile women have been diagnosed with endometriosis. Many women battling endometriosis have pelvic or stomach pain, especially during menstrual bleeding or sexual intercourse. Sometimes, endometriosis can develop inside your ovary and form into a cyst (endometrioma). This should be visible on ultrasound, unlike other endometriotic tissue. The best way to diagnose endometriosis is through laparoscopy.
The reason for endometriosis is as yet unclear. However, there are a few theories which include:
- Retrograde menstruation: In retrograde menstruation, the lining of the womb flows in reverse through the fallopian tubes and into the abdomen (instead of leaving the body as periods). For some, these tissues append onto pelvic or stomach organs or walls, resulting in endometriosis.
- Genetics: You are likely to be affected by endometriosis if a female member of your family (particularly a parent or sibling) has endometriosis.
- Immune system: A weak immune system may make it harder for the body to dispose of tissues. This pose an issue for women with low immune systems, who might be more prone to endometriosis.
- Environmental: Certain toxins in the environment that affect the immune and reproductive system are thought to cause endometriosis, yet this has not been proven in people yet.
- Lymphatic or circulatory spread: A few tissue cells can travel around the body in the bloodstream or different vessels to various parts of the body.
3] Endometriosis and Fertility
Endometriosis is linked to infertility as it can block the fallopian tubes and damage the ovary. As seen above, it can also cause pain during sexual intercourse, which makes getting pregnant with endometriosis a lot harder.
There is a staging system for evaluating endometriosis, which is as follows:
Stage I: There are a few implants (specs) of endometriosis, with no scar tissue seen.
Stage II: There are a few implants of endometriosis. However, under 2 inches of the abdomen are involved, and there is no scar tissue.
Stage III: There is quite a bit of endometriosis in the abdomen which might be deep and may make pockets of endometriotic liquid (chocolate cysts, or endometriomas) in the ovaries. There might also be scar tissues around the tubes or ovaries.
Stage IV: Huge amount of endometriotic tissues in the ovaries, conceivable scar tissue between the uterus and rectum (lower part of the digestive tracts), and around the ovaries or fallopian tubes.
4] Medical Treatment of Endometriosis–related Infertility
Before starting any fertility treatment, a total fertility assessment needs to be performed. This can incorporate hormone and blood testing and checking the partner’s sperm count. Clinical medicines rely upon the stage of a patient’s endometriosis while also having positive chances of getting pregnant with endometriosis.
4.1 STAGE I-II – Endometriosis clomiphene IUI treatment
To work on the probability of pregnancy, clomiphene citrate fertility medicine is authorised for 5 days not long after the menstrual period begins.
The sperm sample is taken from the male partner and is brought to the fertility lab and examined.
When the women starts ovulating, the sperm is set into the uterus with a thin tube. This is done during a speculum test (similar to a Pap test).
The probability of having a child with one treatment of clomiphene/IUI is roughly 10% for women under 40 years of age.
4.2 STAGE III-IV – Endometriosis
If the women doesn’t conceive within six months to a year after the surgical treatment of moderate to severe endometriosis, in-vitro fertilization is recommended. At times the fallopian tubes may be blocked, and the scar tissue may be extremely severe. In certain circumstances, the doctor may suggest direct fertility treatment with in-vitro preparation.
4.3 In-Vitro Fertilization (IVF)
Before you start this treatment, the doctor will explain the possible chances of in-vitro fertilization working for you solely based on your age and hormone testing.
This treatment requires a woman to take small injections of fertility medication which make many eggs grow in the ovaries inside fluid pockets called follicles. These follicles are tracked with blood and ultrasound tests.
At the point when the follicles are a certain size, the eggs are fit to be removed from the ovaries. This is done under a light sleeping sedation (anaesthesia).
Using a needle directed by ultrasound, the developed eggs are removed. This process requires around 10 minutes. The eggs are then placed in a dish with the sperm in the fertility laboratory.
A couple of days after the eggs are removed from the ovaries, the woman returns to the fertility centre and one or a few embryos are placed into the uterus with a thin tube, through the cervix, during a speculum test.
The probability of pregnancy from one attempt of in-vitro preparation goes from 50% or higher for women in their 20s to just 10% for ladies in their 40s.
Medical Attention & Treatment By Women Healthcare
Conceiving with endometriosis is really difficult, but there is a treatment for every disease. Diagnosis of endometriosis through physical assessments and tests can be challenging, and as such, the best way to decide whether you are suffering from this condition is through Laparoscopy. As a Gynaecological specialist, following consultation, Mr N. Agarwal will carry out the following preliminary test:
- Pelvic ultrasound scans
- CA125 blood test (ovarian cancer screen)
Endometriosis is surely painful, but it doesn’t have to be that way forever. Stay open to different possibilities provided by the best gynaecologist and work along with them in getting yourself treated with great and effective medication today! Contact us to book an appointment today!