Getting Pregnant When You Have Endometriosis

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Can you get pregnant with endometriosis? Perhaps you’ve been trying to conceive unsuccessfully for some time, and now, after a fertility evaluation and diagnostic laparoscopic surgery, you have been diagnosed with endometriosis. Or maybe you haven’t even started thinking about having children yet, but after experiencing pelvic pain or severe menstrual cramps, doctors have investigated and diagnosed you with endometriosis.
Endometriosis is the growth of endometrial cells in more than one normal location, the inside of the uterus. When a woman with the disease has her monthly period, the blood and tissue shed from the endometrial growth has no way of leaving the body, hence resulting in internal bleeding, inflammation that may result in pain, adhesions and bowel problems.
Getting pregnant with endometriosis is quite often a big challenge, but it is possible. There are no guarantees but there are possibilities. You can conceive with endometriosis. You may (or may not) require surgery or fertility treatments to make it happen. But it’s a real possibility.
Around 30 – 50 percent of women with endometriosis will experience infertility, that is, the inability to conceive with unprotected, regular sexual intercourse after one year. Some infertile women are six to eight times more likely to have endometriosis than those who don’t struggle to conceive. In one in four couples who receive a diagnosis of unexplained infertility, many of them may actually be dealing with mild endometriosis. However, because endometriosis can only be diagnosed with invasive diagnostic laparoscopic surgery, it appears that there is no “cause” for their infertility.
For couples with unexplained infertility and no pelvic pain, whether or not having surgery for diagnosis, endometriosis is often a controversial topic. If you have been diagnosed with endometriosis before trying to get pregnant, it is worth trying to get pregnant on your own first, before  seeking fertility treatment.
Talking to your doctor about your particular situation helps, but endometriosis doesn’t automatically mean you will experience infertility. After trying for six months on your own you may seek fertility help if you don’t conceive.
If you’re having endometriosis, you may decide to go straight to a fertility specialist and not try to conceive naturally first. If you’re 35 or older, you may not want to take the time to try to conceive on your own. Natural fertility declines with age at a faster rate after age 35, and those extra six months—especially because you already know you have endometriosis—may not be wise. It helps to discuss your particular situation with your doctor.
Normally, women with endometriosis, who are not trying to get pregnant, are  given birth control drugs to lessen pain symptoms.
It’s important to know that the birth control pills don’t cure or “treat” endometriosis. They simply reduce uncomfortable symptoms by suppressing the hormones that feed the endometrial deposits.
For moderate to severe endometriosis, surgery may be required to remove endometrial lesions or cysts. Surgery can reduce pain, but repeated operations can cause scar tissue. The scar tissue may increase the risk of infertility and even increase pain.
In very severe cases of endometriosis, the uterus, ovaries, or part of the ovaries may be removed. However, surgical removal of the reproductive organs isn’t a cure for endometriosis. You may still experience pain. Before having the surgery, talk to the reproductive surgeon in detail about  future fertility plans. Be fully informed about all the risks and benefits.
Understanding how endometriosis impacts fertility is quite complex. When endometriosis causes ovarian cysts (which may interfere with ovulation), or when endometrial scar tissue blocks the fallopian tubes, the reason for infertility is clearer. However, women with endometriosis who don’t have endometrial ovarian cysts or blocked fallopian tubes may still experience reduced fertility.
Endometrial lesions can cause car tissue—or adhesions—to form. These adhesions may pull on the reproductive organs, impeding their ability to function normally. Adhesions may also cause fallopian tube blockage, which can prevent the egg and sperm from meeting. Women with endometriosis have biochemical signs of increased inflammation. But questions abound.  Does the endometriosis cause the inflammation? Or does inflammation increase endometriosis? And how does it all relate to infertility?
While endometriosis is a condition that causes endometrial-like tissue to grow outside of the uterus, it may also affect the endometrium itself. Embryo implantation rates are lower in women with endometriosis.
However, it’s possible lower embryo implantation rates are due to problems with the endometrium but are related to poor egg quality. Some research on IVF has found that women with endometriosis who use donor eggs have similar embryo implantation rates to women without endometriosis.
Women with endometriosis may have lower egg quality and the embryos from them develop slower than average. Also, when an egg donor has endometriosis, and those eggs are used in a woman without endometriosis, the resulting embryos tend to be of lower quality and implantation rates are negatively affected.
There are levels of severity of endometriosis, depending on the location, amount, and depth of endometrial deposits. There is Stage I, Stage II, Stage III, and Stage IV. These stages are used to help describe and evaluate the severity of endometriosis, with Stage I being mild endometriosis, and Stage IV being severe. Now  do these stages mean anything with regards to your fertility or your odds of conception? The answer is yes and no.
Women with Stage I and II endometriosis are less likely to experience infertility than women with Stage III and IV. Also, the stage of endometriosis can help your doctor come up with a treatment plan.

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