Pregnancy with endometriosis: is it possible?
Every tenth woman of fertile age is faced with the manifestations of this disease. Its causes are little known, and the complications are very serious. One of the consequences of endometriosis is infertility. A timely visit to a doctor in the early stages increases a woman's chances of a happy motherhood, even with such a difficult diagnosis.
Content:
- How many women with endometriosis are infertile?
- The Importance of Diagnostic Laparoscopy in Failed Attempts
- Is it possible to get pregnant with endometriosis?
- Impact of endometriosis on fertility
- When is pregnancy possible after endometriosis?
- Pregnancy after laparoscopy
- Will IVF help?
- Endometriosis in early pregnancy
- Answers to popular questions
- Can the stomach hurt with endometriosis?
How many women with endometriosis are infertile?
The diagnosis of "infertility" is given to women who did not become pregnant with regular unprotected sex for a year, that is, the absence of pregnancy for 3-4 months in this case is not considered critical. If the symptoms of endometriosis remained outside the diagnosis of this disease, and it reached a late stage of its development, approximately 30-50% of women with this pathology, according to the researchers of the problem, are infertile.
The Importance of Diagnostic Laparoscopy in Failed Attempts
According to rough estimates, one in four couples treated for infertility cannot have children due to undiagnosed endometriosis in the initial stage. In women undergoing examination for infertility, endometriosis is found 6-8 times more often than in other categories of patients. One of the reasons for this is a detailed study of the state of the reproductive organs using diagnostic laparoscopy.
Most often, these women can still be helped to remove the diagnosis of infertility, to give them the opportunity to conceive and give birth to a child.
Find out more: Laparoscopy of the fallopian tubes: indications and contraindications
Is it possible to get pregnant with endometriosis?
The main obstacles to conception with endometriosis:
- Hormonal imbalances (excess estrogen and lack of progesterone) lead to a lack of ovulation;
- The endometrium can be so affected by the disease that the fertilized egg is fixed on the cervix, provoking a miscarriage;
- Adhesions in the fallopian tubes prevent the oocyte from getting there;
- The walls of the uterus, due to the germination of endometrial cells in them, become loose, do not give the embryo the opportunity to gain a foothold.
In the early stages of the disease, a woman does not lose the opportunity to become pregnant naturally, so it is too early to talk about infertility here. If natural conception is planned, it is necessary that chronic endometriosis is in remission, and not exacerbation.
If, within 6 months, all attempts to conceive have been ineffective, the help of a reproductive specialist should be taken. In the early stages of the disease (up to six months), no radical measures are taken. The exception to this rule is the woman's age. If he is approaching 35, it is not recommended to spend time trying to get pregnant on his own, since this age is considered the threshold, after which fertility begins to decline sharply. This means that the chances of conceiving are decreasing every day.
Impact of endometriosis on fertility
In case of failure with natural conception, the doctor prescribes a course of treatment. Many women express concerns about the possibility of getting pregnant after surgery and the desire to keep their baby healthy. Hormone therapy is not at all dangerous for the future fetus. But the ability to conceive can be partially or completely lost as a result of surgery.
The fact is that with a moderate or severe form of the disease, repeated removal of the areas affected by endometriosis will be required. Each subsequent operation will lead to scarring on the wall of the uterus, reducing the woman's chances of becoming a mother. If the disease has become severe, removal of the uterus and partial or complete removal of the ovaries is required. After hysterectomy and ovariotomy, fertility is completely lost.
In drug therapy for endometriosis, the drugs of choice are hormonal contraceptive pills. They do not cure the disease, but relieve its symptoms. As soon as a woman stops taking drugs, the ability to fertilize returns to her.
Reasons for decreased fertility:
- Formation of an ovarian cyst that prevents ovulation;
- Blockage of tubal permeability by endometrial cells;
- Formation of adhesions and scars in the uterus;
- Adhesion due to the inflammatory process, which prevents the embryo from fixing to the walls of the uterus.
When is pregnancy possible after endometriosis?
After treatment ends, the likelihood of getting the desired pregnancy increases. However, it may take 6 months to a year for the reproductive system to fully recover. If after this pregnancy does not occur, you should undergo a full examination under the guidance of a doctor to exclude all possible causes of infertility.
Pregnancy after laparoscopy
If there are indications in the form of adhesions in the fallopian tubes, laparoscopy is prescribed. This surgery aims to remove the overgrown endometrium and remove adhesions. Although laparoscopy is very effective, its effect does not last long, so it is recommended to plan a pregnancy before relapse occurs.
In the absence of pregnancy within a year after this surgical intervention, it is recommended to undergo an in-depth examination to find the true cause of infertility.
Will IVF help?
If a woman uses her eggs, then during in vitro fertilization, problems with embryo implantation are possible. Donor eggs significantly increase the likelihood of a successful IVF outcome in a patient with endometriosis. The chances are almost equal to those of fertilization in women who do not suffer from this pathology.
Endometriosis in early pregnancy
If conception occurs with endometriosis, and pregnancy has occurred, there is a high probability of miscarriage in the first and second trimesters. The reason for this threat is a deficiency of progesterone, which normally prevents the uterus from contracting and creates a favorable hormonal background. A pregnant patient with endometriosis must be constantly under medical supervision in a hospital setting.
Once the placenta has finished forming, the risk of miscarriage is greatly reduced. This disease does not affect the development of the fetus, it does not cause pathologies.
If symptoms of endometriosis are absent, and pregnancy has occurred, an undiagnosed condition can lead to a recurrent first trimester miscarriage. Therefore, pregnancy must be planned in advance, approach to conception with the highest possible level of immunity, and be regularly examined.
During pregnancy, therapy for the underlying disease is not performed. The only exception is the endometrioid ovarian cyst, which can rupture. In this case, at 16-20 weeks of pregnancy, the formation is removed. Childbirth and breastfeeding will have a positive effect on the course of endometriosis.
Video about whether pregnancy is possible with endometriosis:
Answers to popular questions
Should endometriosis be treated? The disease must be treated without waiting for the spontaneous elimination of endometriosis during menopause.
Consequences if untreated:
- Infertility due to adhesions;
- Rupture of organs with extragenital endometriosis (lungs, bladder, intestines);
- Anemia and lowered immunity due to vaginal, intestinal and pulmonary bleeding;
- Lack of appetite;
- Lethargy, apathy;
- Insomnia;
- Deterioration of hair and nails;
- The development of depression.
Is endometriosis visible on ultrasound? Even with a pronounced process in the uterus and ovary, it is impossible to determine with 100% accuracy the presence of a disease using ultrasound. The most accurate method is laparoscopy with a biopsy.
Is it possible to sunbathe with endometriosis? Solarium, exposure to the sun, steam bath, sauna, hot bath - all this is prohibited in order to avoid increased heat exposure and the development of complications.
Is it possible to play sports with endometriosis? Physical activity with this disease is encouraged, but without high stress. Jogging in place, aerobics with the use of "inverted" poses is very useful.
Can the stomach hurt with endometriosis?
Most often, the lower abdomen hurts, but there may be pains of a different nature:
- With endometriosis of the uterus - spasmodic or paroxysmal pain in the lower abdomen, radiating to the lower back, intensifying during sexual intercourse;
- With ovarian endometriosis - acute pain with urge to vomit, aggravated during menstruation, in advanced cases may result in fainting;
- With vaginal endometriosis - severe pain when urinating, sexual contact;
- With superficial endometriosis - mild pain in the lower abdomen with intimacy;
- With the defeat of the retrocervical space - paralyzing pain in the rectum, vagina, groin.
Can there be delays in endometriosis? Yes, it may be due to a hormonal imbalance, as well as due to the defeat of this pathology of the ovaries.
Can you have sex with endometriosis? Sexual life is not contraindicated in this disease, however, some restrictions are imposed on it. Intimate contacts in advanced stages of the disease can cause vaginal bleeding and pain when endometriotic lesions are damaged.
It is recommended to less frequently plan sexual contacts in the first half of the menstrual cycle, since at this time, under the influence of estrogen, there is a rapid growth of foci of the disease and a deterioration in the woman's well-being.
Endometriosis is a non-communicable disease and is not sexually transmitted.
Is IVF done for endometriosis? In vitro fertilization is performed if indicated.
Firstly, this is the prevalence of the disease - with adhesions and obstruction of the fallopian tubes, cysts in almost 90%, this method allows a woman to become pregnant. If there is inflammation or hormonal imbalance, this figure is much lower.
Secondly, the ineffectiveness of the previously carried out treatment - if, after drug therapy, the woman did not manage to become pregnant.
Thirdly, the age of women - up to 35 years before using IVF, choose a wait-and-see tactic for a year, after this period a short course of hormonal therapy is prescribed and an artificial insemination procedure is performed.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
