The shortest answer to this question is YES!
Though it is a slightly longer road than usual it is possible for women with Endometriosis to get pregnant!
And here we are going to remove all sorts of doubts that come into the couple/mother’s mind while trying to have a baby while suffering from endometriosis.
Let’s get started!
First of all:
What is Endometriosis ?
To answer this question let’s have a look at different layers of the uterus:
The uterus or the womb (the place where the baby grows) has 3 distinctive layers, starting from the inside we have:
Endometrium: the innermost layer that lines the uterus and is responsible for various secretions and menstrual process. (Also, provides nutrition to the growing fetus).
Myometrium: it is the middle muscular layer which is the thickest of all three and comprises mostly of smooth (involuntary) muscle fibers.
Perimetrium: it is the outermost serous layer covering the uterus.
Endometriosis is one of the leading causes of infertility among women. It is a painful condition where the tissue which is supposed to grow inside the uterus starts growing outside, leading to the blocking of fallopian tube, covering of ovaries and other parts of the female reproductive tract.
The endometrial tissue despite of its site continues to function similar to the actual endometrium, i.e, it sheds during the menstrual cycle leading to the buildup of blood at the places where it’s not supposed to be.
Over the course of time, this blood and fibrous tissue can prevent the release of egg from the ovaries, block the fallopian tubes, or in some cases even destroy the sperm or ovum due to the body’s increased inflammatory response in certain cases.
Symptoms of Endometriosis:
Symptoms of endometriosis vary from woman to woman; some might not even have any symptoms at all.
However, some of the most common symptoms of the disease are:
Painful, heavy or irregular periods
Pain in the lower abdomen, pelvis or lower back around ovulation time, but also throughout the cycle
Prolonged pelvic pain lasting six months or longer
Pain during or after sexual intercourse
Painful bowel movements and emptying of bladder (passing of urine)
And, some of the rare symptoms include:
Bleeding from the back passage (Anus)
Painful abdominal scars or pain around belly button, especially during the menstrual period
coughing up blood (very rare)
The symptoms mentioned above can be corrected by the help of a surgeon but endometriosis can also affect the hormonal chemistry of the body and even lead the immune system of the body to attack on the fetus.
How is it diagnosed?
Since the symptoms of endometriosis are similar to a wide range of other gynecological conditions, it can be hard to get a diagnosis but if you have one or more symptoms from the first list above, your doctor should suspect endometriosis and advice you an abdominal and pelvic exam.
The examination goes as follows:
The doctor manually palpates (feels) areas in your pelvis and abdomen for abnormalities, such as cysts on your reproductive organs or scar tissue behind your uterus.
If the symptoms are severe and persistent and/or the pelvic/abdominal exam shows symptoms of endometriosis then you may be referred for an ultrasound scan. Even if the scan shows no signs, you may be referred for a laparoscopy if your symptoms are severe and persistent.
Laparoscopy is a surgical procedure that allows the surgeon to look inside your abdominal cavity for any signs of endometriosis. While you’re under general anaesthetic, the surgeon makes a tiny cut near your umbilicus (navel) and inserts a small thin lit tube called a laparoscope, looking for endometrial tissue outside the uterus. They may take samples of tissue. Laparoscopy can provide information about the location, extent and size of the endometrial tissue (called implants). If a full systematic laparoscopy doesn’t show any signs, then you do not have endometriosis.
Stages/severity of endometriosis:
The American Society of Reproductive Medicine has developed a staging system to classify the severity of endometriosis. The system for defining the stages of the endometriosis aims at the amount of tissue that has grown and its location, which means that it doesn’t always reflect the amount of pain you might have or the risk of infertility. It is possible for a woman in stage 1 to be in pain for example, while a woman in stage 4 has no pain at all.
The stages are termed as follows:
Stage 1: Minimal
Stage 2: Mild
Stage 3: Moderate
Stage 4: Severe
Now that we have all the facts on the disease let’s have a look at various treatment options available for endometriosis that can help in the conception of a baby.
Treatment: Ways to become pregnant with endometriosis:
Treatment for endometriosis begins with asking the patient to stop taking painkiller medications such as- NSAIDs since they can alter the process of conception.
The most common treatment options available are:
Hormonal treatments: hormonal therapy is used to treat endometriosis by altering the various hormonal levels of the body. It is done using contraceptive medication and mimics the state of pregnancy. However, hormonal therapy is stopped when the couple is trying to have a baby.
Surgery: surgery can improve the fertility rates for those with minimal or mild endometriosis.
The most common type of surgery is laparoscopy, also known as keyhole surgery. This involves a thin tube with a camera at the end being inserted into your abdomen through a small cut made in your skin, usually your belly button. Through this camera and possibly additional small cuts around your bikini line either laser or heat or scissors can be passed to remove or destroy the tissue under general anesthesia.
This is an effective treatment but there is a risk of some tissue being left behind or re-growing, so the endometriosis can recur.
The other type of surgery that can be performed is a laparotomy. This surgery is only done in very few exceptional cases as it is more invasive with a wider cut along the bikini line and removal of the tissue attached to the affected area.
In vitro fertilization (IVF): This treatment involves the extraction of an egg from your ovary and sperm from your partner. The egg is then fertilized outside the body and implanted into the uterus using artificial insemination techniques.
Superovulation and intrauterine insemination (SO-IUI): This is an option for women who have normal fallopian tubes, mild endometriosis, and whose partner has good-quality sperm.
Here, the chances of conception are increased using medications to increase the no. of eggs released during a menstrual cycle and the intra-uterine insemination of sperm.
How can you improve your chances of conceiving with endometriosis?
It is important to live as healthy a lifestyle as possible when you have endometriosis and are trying to get pregnant. This helps in reducing the inflammation in your body and prepares it to help your baby grow and thrive throughout a healthy pregnancy.
Some steps that you can take to insure a healthy pregnancy include:
engaging in moderate exercise on a daily basis (examples include walking, lifting weights, and participating in an aerobics class)
maintaining a healthy weight
eating a healthy diet rich in fruits, vegetables, whole grains, and lean proteins
Age is an important factor that affects the fertility in women. Higher fertility rates are associated with younger age. Women that are above the ages of 35 years and older are at a greater risk for both infertility and miscarriage than younger women (less than 30 years of age).
Risk factors associated with Endometriosis:
Women with endometriosis have higher rates of:
The good news out of all of this is that there are many women who conceive and ultimately deliver a healthy baby every day with endometriosis. The key point here is to start exploring the various options available for conception. You should see your doctor if you are not able to conceive after at least a year of unprotected sex with your partner.
If you need any further information, you can contact us at Chaitanya IVF Hospital or call us at 7355621680