There are a few reasons why women with endometriosis might feel a little bit of extra urgency when trying to conceive. Because endometriosis is a condition that grows and progresses, many women are encouraged to try to conceive earlier than they otherwise might, if they’re hoping to carry children, which can lead to the feeling of working with a deadline.
Additionally, many women find they don’t experience the symptoms of endometriosis during pregnancy, or even during breastfeeding. For some women, symptoms don’t come back even after weaning. Unfortunately, endometriosis can also hurt women’s fertility, which can make the TTC process longer and harder than it might normally be.
It’s hard to tell exactly how many women with endometriosis face symptoms of lowered fertility, but it’s estimated that less than half of women diagnosed with endometriosis face some degree of infertility.
Unfortunately, many of the common and effective ways of treating endometriosis medically instead of surgically can’t be used while trying to conceive, since these methods affect hormonal responses, and some are actually originally contraceptives, like the birth control pill, that also happen to treat endometriosis symptoms.
This means that, while trying to conceive, many women with an earlier diagnosis of endometriosis have a return of symptoms, or even a spread and increase of the condition.
Studies show that women with mild to moderate endometriosis who treat it surgically, by removing endometriomas and scar tissue through a laparoscopy (the same operation that’s most often used to diagnose endometriosis) raise their chances of natural conception slightly, but since it’s only a slight improvement of odds, it’s not always recommended. Surgical removal of endometriosis tissue is only practical in certain cases, where the condition hasn’t grown as extensively as it does in others.
Conceiving with help
For women with endometriosis who are diagnosed with infertility – women who have been trying to conceive for 12 months without it resulting in a pregnancy – the assisted fertility method that’s considered to be the most effective is in vitro fertilization, or IVF.
In IVF, the sperm and the egg are both extracted and combined to make an embryo outside of the body, in a laboratory. Then the embryo is sent into the uterus to (hopefully) implant. This keeps the endometriosis from getting in the way of the sperm meeting the egg, and it also keeps the substances the endometriomas produce from affecting the sperm or egg before fertilization.
IVF has a lower success rate for women with endometriosis than it does for women experiencing infertility for other reasons, but it’s a good option, especially for women who feel discouraged about trying to conceive naturally. IVF is usually combined with fertility drugs that help stimulate ovulation. Young women with endometriosis may choose to have their eggs frozen and stored in a laboratory, should they want to try IVF at a later date.
Pregnancy with endometriosis
Many women with endometriosis find that their symptoms can decrease or even go away entirely during pregnancy. On the other hand, though, other women with endometriosis may continue to experience symptoms, or even to have symptoms come back, if they’ve been gone a while. Women who experience some relief from endometriosis symptoms during pregnancy may hold onto that relief after birth, too, while they’re breastfeeding.
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Suneeta Senapati, Kurt Barnhart. “Managing Endometriosis Associated Infertility.” Clin Obstet Gynecol. 54(4): 720–726. Web. December 2011.
“In vitro fertilization (IVF).” MedlinePlus. U.S. National Library of Medicine, March 11 2013. Web.
Milroy J. Samuel. “Endometriosis During Pregnancy.” PregnancyCorner. IMG Health Publications, August 2015. Web.