Overview of Endometriosis
The uterus in the pelvic of the female body consists of a lining, called the endometrium lining which thickens over the menstrual cycle and finally breaks down and sheds blood that passes through the vagina. Sometimes, the endometrium tissue grows outside the uterine lining. This tissue has the same characteristics as the endometrium, which means it will grow, break down and bleed.
Normally the blood is passed through the vagina but since the endometrium-like tissue is formed outside the uterus, it can get “trapped” inside the body. This condition is called endometriosis. It can range from minimal to severe ascending through four stages. It can cause extreme menstrual pain along with heavy or irregular periods. Minimal and mild stages have minor lesions but moderate and severe cases can have cysts in either or both the ovaries.
How it affects Pregnancy?
Studies have shown that women with severe endometriosis can have difficulty getting pregnant. In the case of mild and minimal stages, conceiving might not be very difficult but considering the location of the disorder, there is a possibility of anatomical changes causing infertility. It has been found that around 70% of women with minimal to moderate stages of endometriosis didn’t have any problem getting pregnant.
Normally, to get pregnant the sperm must meet the egg and unite to form a zygote. With women having severe cases of endometriosis, cysts may be formed around the fallopian tube preventing the egg to unite with the sperm. Otherwise too, the disorder may directly damage the egg or the sperm. Even though it is not definite that endometriosis will cause infertility but studies have shown that infertility can raise the risk of getting endometriosis by 6-8 times.
While it has been seen that there are very rare cases of complications caused due to endometriosis during pregnancy, there is an increased risk of placenta praevia or low-lying placenta.
Chances of Natural Pregnancy with endometriosis
Women with endometriosis with minimal to moderate cases can conceive naturally. Although in some women that may be the problem hence there are several ways through which you can boost your chances of getting pregnant:
- Painkillers– Endometriosis can cause painful intercourse, so if you find it unbearable to get through, painkillers like paracetamol, anti-inflammatories, non-steroidal painkillers, etc can help in these situations. However, it is ill-advised to take regular painkillers as you start getting immune and it is extremely unhealthy for the baby.
- IVF– Intrauterine insemination (IUI) or In Virto Fertilisation (IVF) are some Assisted reproductive techniques (ART) that may increase your chances of getting naturally pregnant. An IVF is recommended after two years of an unsuccessful attempt considering that the semen quality is good and ovulation is normal.
- Surgery– Surgery can be done with minimal to mild symptoms of endometriosis after getting advice from your doctor. Even then regrowth can occur but surgery can significantly improve your chances. The most common surgeries are laparoscopy or keyhole surgery, where a thin tube with a camera is inserted through a tiny incision on the abdomen and either through laser, or heat, or scissors the tissue is destroyed and laparotomy which has a rather wider cut along the bikini line and removal of the tissue.
Can it cause miscarriage?
While there is no proper evidence to show the effects of endometriosis over the miscarriage. However, two databases from Sweden and Scotland may suggest that there is a link between endometriosis and miscarriage. The study in Sweden found that 20% of women are more likely to have a miscarriage if they have endometriosis.
Almost similar results were found in Scotland. With that being said, women who went through the keyhole surgery did not show any benefit over a miscarriage.
Endometriosis is a painful disorder with mild to no symptoms in the initial stages. It is completely hormonal. There is no cure yet but eating healthy food and fruits and drinking plenty of water will help you live a healthy life.
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Dr. Jay Mehta
Fertility and IVF Specialist
Dr. Jay Mehta is the Scientific Director of Shree IVF Clinic. He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology.