Guest article from everydayhealth.com
Life isn’t easy for anyone battling a chronic pain disorder. For women with endometriosis, this fight can be even harder. Every day is a struggle and most people simply don’t understand how endometriosis affects you.
For some women the pain and fatigue can be so overwhelming that it’s hard to even get out of bed each morning. Of course, not every woman experiences the same endometriosis symptoms or with the same degree of severity. However, most share a common fear or anxiety about the ability to conceive.
The Impact of Endometriosis on Fertility
Most women can endure the pain and discomfort of endometriosis, but the idea of not being able to have kids of your own is a lot more terrifying. While the numbers may be disheartening, it’s important to note that not every woman with endometriosis suffers from infertility. Here’s what we know.
Roughly 30 to 50 percent of women who suffer from endometriosis are likely to experience infertility. Endometriosis is a common cause of infertility, often diagnosed after the identification of fertility problems. In fact, research indicates that infertile women are far more likely to be diagnosed with endometriosis than other women.
Experts also believe that in 25 percent of the cases involving couples with unexplained infertility, mild endometriosis is the most likely cause. This comes as no surprise, since 1 in 4 women who develop endometriosis experience no symptoms.
How Endometriosis Can Cause Infertility
Endometriosis is known to cause infertility when endometriomas occur in the ovaries. Research shows that this affects up to 44 percent of those diagnosed with endometriosis. In fact, 35 percent of all benign ovarian cysts are linked to ovarian endometriomas. In such cases, ovarian cysts can interfere with ovulation or scarring can increase blockage of the fallopian tubes. In other cases, the causes of infertility are not as well understood, but there are several theories.
Obstruction of Reproductive Organs
Endometriosis causes lesions to form, which results in the development of scar tissue or adhesions. Adhesions can impair reproductive function by dislocating or binding together different internal organs, such as the ovaries and uterus. Adhesions are also known to cause blockage of the fallopian tube in cases, making it impossible for fertilization of the egg. This problem is more common in later stage endometriosis.
Endometriosis lesions are known to respond to hormonal stimulation, sometimes bleeding during menstruation. When the blood is not cleared by the circulatory, lymphatic, and immune system it causes swelling, which increases inflammation and activates cytokines.
This is what causes endometriosis symptoms of localized pain. In many women with endometriosis, studies now point to increased signs of inflammation and this is believed to impair fertility.
Reduced Embryo Implantation
Embryo implantation refers to the stage of conception in which the embryo adheres to the uterine walls. This is what allows the embryo to receive oxygen and nutrition to grow. This process is directly impacted in endometriosis, with studies showing lower implantation rates. This could be attributed to the condition’s effects on the endometrium, but it could also be a result of reduced egg quality.
Poor Egg Quality
The idea that reduced egg quality contributes to infertility and poor implantation rates is supported by research. A study that appeared in the journal Fertility and Sterility found that eggs from donors with endometriosis tend to be of lower quality. This means that embryos in women with endometriosis have slower development and this also adversely affects implantation rates.
Endometriosis pain is often overlooked when women have trouble conceiving, but this could play a significant role. While pain during intercourse does not impair ovulation or fertilization,
it can make the act of sex unbearable. The severity of such pain can vary significantly among women and has no correlation with the severity of endometriosis itself. Instead, it depends on the location of endometriomas. Treatment often involves the use of birth control medications, but the pain returns when such treatments are stopped if the patient wishes to conceive.
In case of severe pain, surgical treatments may also be used to remove the cysts or lesions, but this can increase scar tissue build-up, which again poses a risk of infertility.
Getting Pregnant with Endometriosis
Because of the high risk of infertility, most women think that they should first get some kind of fertility treatment. This need not be the case, as infertility is not an inevitable outcome for all women diagnosed with endometriosis.
While you should discuss all options with your doctor, you will most probably be advised to try conceiving without any intervention. Normally, women are advised to try conceiving naturally for at least 12 months before consulting a fertility specialist, but this timeline is reduced to 6 months when dealing with endometriosis.
Many women use natural treatments to cope with endometriosis symptoms and some of these methods could also improve your chances of conceiving naturally. If these efforts fail, there’s still hope as fertility treatments like IVF can be quite effective. In fact, there are stories of women who have had success with IVF despite suffering from stage IV endometriosis.