Endometriosis and Infertility
Endometriosis – that’s a pretty big word! Even though there are links between endometriosis and infertility, if you do have it you’d probably know about it way before you try to have kids. That’s ‘cause one of the symptoms of endometriosis is incredibly painful periods. You see, what happens is that cells that usually only grow inside the uterus grow outside the uterus too, like in the fallopian tubes, vagina, ovaries or other places in the pelvis. The pain of endometriosis is directly linked to your period because those cells start to make that rich blood lining even though they aren’t in the uterus, so when you do have your monthly bleed you end up bleeding from areas outside your uterus as well as from inside your uterus.
Endometriosis and infertility:
• These groups of uterine cells make little cysts or lumps, which may then make scars, which could block the egg and the sperm from meeting each other when you’re trying for a baby. This doesn’t mean that if you do have endometriosis you will definitely have infertility, but it can cause infertility in some women.
• Endometriosis can also make you infertile by making hormones that affect ovulation, fertilization or implantation.
• You probably won’t need any treatment at all to get pregnant if your endometriosis isn’t too severe.
Symptoms:
• You might have endometriosis without any symptoms so if you do battle to get pregnant your doctor will probably test you for endometriosis anyway.
• The first or most obvious symptom of endometriosis is extremely painful periods with cramps that starts before your period and end a day or so after your period. You might also have pain during sex or when you’re on the toilet.
• You might have endometriosis if you have some of these symptoms as well: pain in your lower abdomen or lower back, irregular periods, heavy bleeding, blood in your urine and diarrhea and/or constipation.
Tests:
• Sometimes the doc will be able to tell from symptoms alone if you have endometriosis or not, or he or she might need to do a physical examination. Surgery is generally necessary for a definite diagnosis.
• You might have to go for an ultrasound to check that you don’t have any other problems that could be causing the pain, but again, the doctor needs to actually see the tissue, and maybe even send it off for testing to make absolutely sure that you have endometriosis. This could be through a laparoscopy (small cuts and a little camera) or a laparotomy (big cut).
Treatment:
• None – If you have endometriosis without symptoms then you probably won’t need treatment, but treatment can help to relieve pain and improve fertility.
• Medication – The first port of call for pain relief are NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen or naproxen sodium – but these won’t affect the cells themselves. If these don’t help with your pain, you might need further treatment. Normally medication will involve some change in your cycle because it is the normal hormones like estrogen that make the symptoms of endometriosis so much worse. As with any hormonal treatments, there are some side effects but apparently these are treatable. Obviously, anything that messes with your natural hormones is probably not good for planning a pregnancy, so let your doctor know that you want to get pregnant so that he can choose the best course of action.
• Surgery – is generally better than medication if you are having problems getting pregnant. But you may need medication after surgery as well to prevent the symptoms from returning. If your condition isn’t too bad, they’ll do a laparoscopy and cut or laser the lumps out. The next step would be to do a laparotomy, which is where they make a bigger cut, like a Caesar cut, to fix things up. If your endometriosis is very, very, very bad, you might have to have your uterus removed and obviously this has implications for your fertility.
So even though there are links between endometriosis and infertility you will probably still be able to get pregnant without any treatment, although you might like to have treatment for the pain if it is really severe. Apparently, about 10% of women suffer from some form of endometriosis, so you aren’t alone, and you know that those in the know are working on better treatments all the time.
