30 to 50 percent of women with endometriosis struggle with infertility. Here’s how to identify the symptoms and figure out your options.
Endometriosis affects 200 million women worldwide and can strike girls as young as age 11. It occurs when tissue similar to the uterine lining (the endometrium) grows elsewhere in the body, causing pain and inflammation. Endometriosis is most often found on the outside of the uterus, on the ovaries or fallopian tubes, or even on the bladder or intestines. The result is irritation and discomfort, which worsens along with fluctuations in the menstrual cycle.
The most common symptom of endometriosis is pelvic pain, especially during sex, menstrual bleeding, or ovulation. In addition, around 30 to 50 percent of women with endometriosis also experience infertility. When infertility occurs, it’s often because endometriosis has formed on the ovaries, creating a cyst called an endometrioma.
It’s also possible that endometriosis has distorted the anatomy of the pelvis, scarred the fallopian tubes, inflamed the pelvic structures, altered the eggs’ hormonal environment, or impacted egg quality. With the help of a surgical procedure called a laparoscopy, a doctor can diagnose endometriosis and determine if and how it’s contributing to infertility. If endometriosis is to blame for your difficulty conceiving, there are steps you can take to address it.
During laparoscopy, your doctor may offer you a “score” rating the severity of your endometriosis based on its amount, location, and depth. The score indicates whether your endometriosis is minimal, mild, moderate, or severe, which can help determine the treatment that’s most appropriate.
For patients with minimal to moderate endometriosis who are not trying to become pregnant, over-the-counter or prescription pain medication can be a sufficient solution. A doctor may also prescribe hormonal medications, which can lower or block the estrogen that endometriosis needs to develop and grow.
However, neither of these solutions are suitable for women who wish to become pregnant. For these patients, surgery is one possible solution — your doctor may be able to surgically remove or destroy endometriosis during laparoscopy, or may choose to schedule a separate surgery called a laparotomy. Laparotomy is a major open-abdominal surgery that, like laparoscopy, aims to remove the endometrial lesions.
Surgery to remove lesions may improve a patient’s chances of becoming pregnant, but some patients still struggle to conceive even after laparotomy or laparoscopy. For these patients, fertility treatments are often a good option.
Fertility Treatments for Endometriosis
For patients with endometriosis who wish to become pregnant, fertility treatment can be an excellent option, whether or not they’ve already undergone surgery. Two leading fertility treatments for women with endometriosis are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI involves controlled ovarian hyperstimulation, which is a treatment that uses hormonal drugs to stimulate the ovaries into producing additional eggs. After the hormones have been appropriately administered, a partner’s or donor’s sperm is injected directly into the patient’s uterus.
Women with endometriosis who undergo IUI are more likely to conceive than those who attempt to conceive without the help of fertility treatments; however, their success rates with IUI tend to be about half those of other women. If IUI isn’t successful after three to four cycles, it’s usually recommended that women try IVF.
IVF is a fertilization process in which an egg is combined with sperm outside of the body and then inserted into a woman’s uterus. IVF tends to have higher success rates in women with endometriosis than IUI, though it’s still one-third lower than those of women undergoing IVF for other reasons.
If you have endometriosis and wish to become pregnant, or if you’re struggling to conceive and suspect you may have endometriosis, contact New York Reproductive Wellness. With years of experience empowering women and couples to have the family they’ve always dreamed of, we would be honored to help you do the same. Consistently named one of the top reproductive clinics in New York, we promise you’ll be in good hands.