You are currently viewing Pregnancy Chances with Endometriosis: Managing Endometriosis and Fertility Problems

Endometriosis is a complex condition where tissue similar to the lining of the uterus grows outside of it. This can cause inflammation and the formation of scar tissue- nodules in the pelvic area and other parts of the body. Infertility from endometriosis is a widespread issue, affecting around 10% of women worldwide, which adds up to about 247 million individuals globally, with approximately 42 million in India alone facing endometriosis and fertility.

Endometriosis and fertility problems often go hand in hand, being present in about one-third of cases. It’s also commonly found in women who have unexplained infertility (70%), adolescent girls with severe menstrual pain (30%), those experiencing chronic pelvic discomfort (60%), and women with adenomyosis (30%). The effects of endometriosis and fertility issues can be significant, leading to a lower quality of life, feelings of fatigue, depression, anxiety, and of-course above all endometriosis’ impact on fertility.

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So what is the right way to deal with endometriosis and getting pregnant?

Endometriosis: Does It Cause Infertility?

Understanding endometriosis and fertility issues to Improve pregnancy chances with endometriosis:

1. Symptoms of Endometriosis:

Symptoms of endometriosis from Infertility in India mirror those experienced globally, including pelvic pain, heavy periods, pain during intercourse, and bowel or urinary problems. However, cultural and social factors in India may affect the perception and management of these symptoms of endometriosis fertility problems.

2. Stages of Severity in Infertility from Endometriosis:

In India, infertility from endometriosis severity follows the globally recognized staging system, ranging from minimal (Stage I) to severe (Stage IV). However, due to factors like limited healthcare access and awareness, many cases in India are diagnosed at advanced stages. Treatment strategies may vary based on the severity of the condition, ranging from pain management medications to surgical interventions, including a comprehensive surgical excision of the disease by laparoscopy

3. Causes of Endometriosis and Fertility in Women and Men:

Endometriosis is a significant contributor to infertility in India, affecting an estimated 25-40% of women struggling with conception. In men, factors such as environmental pollutants, lifestyle choices, and genetic predisposition can also contribute to infertility.

4. Prevalence of Endometriosis Fertility Problems:

In India, infertility due to endometriosis is a growing concern, with rates varying across regions and socioeconomic groups. Approximately 10-15% of Indian couples face endometriosis impact on fertility.

Relationship Between Endometriosis and Infertility:

Together, endometriosis, and getting pregnant become tough because it affects fertility through various mechanisms. 

  • When affecting the ovary- chocolate cyst – This condition can affect fertility by disrupting ovarian function, leading to reduced egg quality or ovulation issues. Studies suggest that up to 40% of women with endometriosis have compromised ovarian reserve, reducing their chances of conception.
  • Also, infertility due to endometriosis can come from pelvic adhesions or scarring, affecting fallopian tube function and hindering the journey of the egg to the uterus.
  • Implantation may also be compromised due to changes in the uterine environment caused by endometriosis. These factors collectively contribute to decreased fertility rates among affected women. 

Mechanisms of Infertility from Endometriosis:

Infertility from endometriosis can occur due to several mechanisms. 

1. Adhesion formation and tubal dysfunction:

Research indicates that approximately 20-40% of women with endometriosis experience tubal dysfunction due to adhesion formation, where endometrial tissue binds organs together, potentially obstructing the fallopian tubes. This impairs egg transport, leading to tubal dysfunction, thereby endometriosis impact on fertility.

2. Inflammation and immune system dysfunction:

Moreover, studies suggest that up to 50-60% of women with infertility due to endometriosis exhibit inflammation and immune system dysfunction, which can disrupt conception processes. In simple words, this can disrupt the delicate balance needed for conception and resultantly, chronic inflammation may impair egg quality and implantation.

3. Ovarian reserve depletion and follicular dysfunction:

Lastly, endometriosis is associated with ovarian reserve depletion, affecting approximately 25-50% of affected individuals, leading to follicular dysfunction and reduced egg quality or can reduce the number of healthy eggs available for ovulation, causing endometriosis fertility problems.

Diagnosis and Treatment of Endometriosis-Related Infertility:

Challenges in Diagnosing Infertility Related to Endometriosis:

Studies suggest that up to 50% of women with endometriosis experience infertility. However, infertility from endometriosis is often underdiagnosed or misdiagnosed, with an average delay of 6.7 to 11.7 years from symptom onset to diagnosis. This delay can significantly impact fertility treatment success rates. Furthermore, around 20-40% of women with endometriosis are asymptomatic, further complicating early diagnosis and intervention.

Fertility Testing for Women with Endometriosis:

Research indicates that women with endometriosis have a higher prevalence of diminished ovarian reserve, with up to 50% having reduced ovarian function compared to those without the condition. Tests such as anti-Mullerian Hormone (AMH) levels and antral follicle count (AFC) are commonly used to evaluate ovarian reserve in these patients. 

Treatment Options for Infertility Associated with Endometriosis:

Endometriosis Treatment Options
  • Medical Management of endometriosis and fertility, like hormonal therapies, including gonadotropin-releasing hormone agonists (GnRH agonists) and oral contraceptives, are commonly used to manage early-stage endometriosis-related infertility. However, long-term use of GnRH agonists may lead to decreased bone mineral density and menopausal symptoms.
  • Laparoscopic surgery is effective in treating infertility due to endometriosis as well as curing other symptoms of endometriosis like pelvic pain, with studies reporting pregnancy rates ranging from 35% to 60% following surgical intervention. Excision of endometrial implants and adhesiolysis to restore pelvic anatomy can significantly improve fertility outcomes and pregnancy chances with endometriosis.
  • Assisted Reproductive Technologies (ART) like in vitro fertilization (IVF) is often recommended for women with endometriosis-related infertility. Studies indicate that IVF success rates in women with endometriosis are comparable to those without the condition, with live birth rates ranging from 30% to 50% per cycle. However, endometriosis’s impact on fertility, may in-turn impact IVF outcomes, with higher rates of implantation failure and miscarriage observed in some cases.
  • Combining medical management, surgery, and ART may optimize fertility outcomes in women with endometriosis. Research suggests that a multidisciplinary approach involving gynecologists, reproductive endocrinologists, and fertility specialists can improve endometriosis and getting pregnant rates and reduce the time to conception by creating customized plans to treat an individual.

Pregnancy Chances with Endometriosis: Managing Endometriosis and Fertility Problems

Here we adopt a multidisciplinary approach involving gynecologists, fertility specialists, and pain management experts to get rid of endometriosis fertility problems. This collaborative effort ensures comprehensive care addressing both reproductive challenges and pain management.

Also, lifestyle modifications such as maintaining a healthy weight, balanced diet, and regular exercise can improve fertility outcomes.

Equally important is psychological support for individuals navigating infertility due to endometriosis. Counseling and support groups offer invaluable emotional support, helping patients cope with the emotional toll of fertility struggle.

What Future Paths for Parenthood?

Understanding endometriosis and fertility is important to ensure you see doctors who know about both conditions. Don’t be afraid to ask for help when you need it – whether it’s emotional support or medical advice towards endometriosis and getting pregnant. We’re here for you, ready to help you on your journey to better fertility and health. Take the next step towards parenthood by entrusting your journey to the expertise of the best IVF center.

FAQs:

What is endometriosis?

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain and potential fertility issues.

How does endometriosis affect fertility?

Endometriosis can lead to inflammation, scarring, and blockage of the fallopian tubes, hindering the ability of eggs to travel to the uterus and be fertilized.

Can women with endometriosis get pregnant?

Yes, many women with endometriosis can conceive, but it might require medical intervention or lifestyle changes to improve fertility.

What are the treatment options for managing endometriosis and improving fertility?

Treatment options include medications to reduce pain and inflammation, surgery to remove endometrial tissue, and assisted reproductive technologies such as in vitro fertilization (IVF).

Can endometriosis recur after treatment?

Yes, endometriosis can recur after treatment, but managing symptoms and fertility issues remains possible with ongoing medical care and lifestyle adjustments.

Are there lifestyle changes that can help manage endometriosis and improve fertility?

Yes, maintaining a healthy diet, managing stress, avoiding alcohol and smoking, and regular exercise can all contribute to managing symptoms and enhancing fertility.

When should I seek help if I suspect I have endometriosis or fertility issues?

If you experience symptoms such as pelvic pain, heavy periods, painful intercourse, or difficulty conceiving, it’s essential to consult a healthcare provider for proper diagnosis and management. Early intervention can lead to better outcomes in managing endometriosis and fertility problems.

Dr Shefali Jain

Dr. Shefali Jain is Gynecologist, Obstetrician & Infertility Specialist in Indore with more than 27 years of experience in the field of ART with highest success rate. She has received many awards for her exceptional work in the field of infertility. She has been an invited speaker to many national and international conferences.

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