Endometriosis and infertility

Endometriosis is among the most common causes of infertility. In fact, according to the American College of Obstetricians and Gynecologists, about 40% of women who are suffering from infertility have endometriosis.

Fertility complications from endometriosis can be serious, but according to the Mayo Clinic, women with mild to moderate endometriosis can often still conceive naturally, and carry a pregnancy to term. Women hoping to conceive who have more serious endometriosis, or who are having more trouble, may be offered or recommended the help of assisted reproductive technology like in vitro fertilization.

Get a jump on it

Some healthcare providers may suggest that women diagnosed with endometriosis consider having children early, if they decide they do want children, since endometriosis can worsen over time. There are two reasons for this. There may be a few different links between endometriosis and fertility, but one commonly accepted one is that endometriosis can grow in the fallopian tubes, and physically get in the way of the sperm and the egg meeting. Since endometriosis can grow over time, the earlier women with endometriosis try to conceive, the less of a chance there is of this being a problem.

The other potential issue is that, as endometriosis progresses, the pain associated with it can also progress and grow worse. Since the only way to truly and fully cure endometriosis is to remove the reproductive organs and, by doing so, induce an early menopause, it isn’t possible to fully cure endometriosis and then carry a pregnancy afterwards.

While you wait

Women who are diagnosed with endometriosis and want children eventually but not right away may be prescribed hormonal birth control in the meantime, which can limit the spread of endometriosis. Hormonal birth control can also be an effective treatment for pain management of endometriosis. This is because hormonal birth control holds hormone levels more steady than the natural fluctuation of the menstrual cycle without hormonal treatments.

This is important because the endometrial cells outside of the uterus that cause endometriosis still behave just like the endometrial cells inside the uterus, which thicken and stiffen before dissolving and being shed during menstruation. This process happening outside the uterus, which is equipped to handle the cycle, can cause pain that increases over time, as well as interfere with fertility. Hormonal treatment, including hormonal birth control, can limit that process.

Egg freezing may be beneficial for young women with endometriosis. Through this process, eggs are frozen and stored in a laboratory until the time comes that a woman wants to use them with her fertility treatment. 

When the time is right

Women who are diagnosed with endometriosis and are trying to conceive may have a couple of different options to try to help improve their chances of fertility, depending on the specifics of their case of endometriosis.

On one hand, data also supports the idea that surgery to remove endometriosis can improve chances of conceiving naturally, though it won’t cure endometriosis, since endometrial tissue can still grow back. This surgery is more likely to be performed on women hoping to conceive naturally. Removing endometrial growths surgically can also reduce or get rid of pain from endometriosis, sometimes for years at a time.

On the other hand, women who either want to try to conceive using assisted reproductive technologies (IVF is generally agreed to be the most effective for endometriosis) or have been advised that IVF is their best chance to conceive may prepare with hormonal treatments first, although women who have had laparoscopies can also try to conceive through IVF. Women who are undergoing IVF are often prescribed fertility-enhancing medications to induce ovulation. 

Like women facing infertility for other reasons, with careful treatment, many women with endometriosis who hope to conceive will end up carrying babies safely to term.

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  • Jessica R. Brown. “Endometriosis and infertility: what you need to know.” Resolve. National Infertility Association, Winter 2012. Web.
  • “Endometriosis: does it cause infertility?” ReproductiveFacts. American Society for Reproductive Medicine, 2012. Web.
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  • Mayo Clinic Staff. “Endometriosis.” Mayo Clinic. Mayo Clinic, April 2 2013. Web.
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