How can I maximize my fertility for the future?

Often, when adult women are diagnosed with endometriosis, they’re encouraged to have children earlier rather than later, if they want them. This is because endometriosis is a disease that progresses, and the most effective treatment for late-stage endometriosis is the removal of the uterus and ovaries, which starts menopause early and makes conceiving a child later impossible. Sometimes, though, an endometriosis diagnosis comes months or years before a woman is thinking about children. So what’s the best way to make sure you’ll be fertile later if you have an endometriosis diagnosis now?

Consultation with a specialist

Even if you’re not trying to get pregnant, you might want to consider meeting with a fertility specialist to learn about and discuss your fertility. Fertility specalists are extensively trained to give you relevant and helpful information about your body and your health, as they relate to endometriosis and fertility. Seeing a specialist is especially a good idea if you’re over age 30 or if you’ve had a blood test that determined that you have decreased ovarian reserve. 

Hormonal treatments

There are two main reasons to treat endometriosis medically. The first is to limit pain and try to relieve other symptoms of endometriosis. The second is to stop the spread and growth of endometriosis. Different treatments work in different bodies differently, so it may take some experimentation to find a hormonal treatment that your body responds well to, but when hormonal treatment for endometriosis works the way it’s designed to, it should keep endometriosis growth from spreading to the next level. One of the most common ways to treat endometriosis medically is for women to take a continuous dose of the birth control pill.

Unfortunately, when you do choose to try to conceive, you’ll need to stop taking hormonal medication, which may make endometriosis symptoms return, and may allow the endometriosis tissue to spread. Until then, though, hormonal medications should help to keep your fertility fairly stable, aside from the normal changes that happen with age.

Surgical treatment

Surgical treatment is often recommended if endometriosis isn’t responding to hormonal treatment or if, for some reason (like trying to conceive), it’s not practical to continue taking hormonal treatment. Laparoscopic surgeries, which use the same kind of incision as the operation to diagnose endometriosis, can be used to remove endometrial tissue, which can improve fertility as well as endometriosis symptoms. Removing endometrial tissue laparoscopically has been shown to improve chances of conceiving naturally.

Many women and their healthcare providers who choose to try IVF perform IVF before trying to remove endometriosis tissue laparoscopy, but some evidence suggests that surgery to remove endometrial tissue can improve the chances of IVF being successful. This is true even in cases where IVF hasn’t been successful in the past.

Egg freezing

Women’s fertility changes over time, and these effects can be even more pronounced for women who have a progressive condition such as endometriosis. As a result, it’s not uncommon for women with endometriosis to have some of their unfertilized eggs frozen and stored in a laboratory for future use. This process allows them to put off pregnancy until they’re ready to start trying. This procedure can be expensive, and it’s not often covered by insurance, but more and more women are using this option to preserve their fertility for the future. 

  • “Treating endometriosis.” thewomens. The Women’s The Royal Hospital Victoria Australia. Web.
  • Michelle L. Brandt. “Laparoscopic procedure can help to treat infertility.” Stanford News. Stanford University, January 18 2006. Web.
  • Jessica R. Brown. “Endometriosis and infertility: what you need to know.” Resolve. National Infertility Association, Winter 2012. Web.
  • The Practice Committee of the American Society for Reproductive Medicine. “Endometriosis and infertility: a committee opinion.” ASRM. American Society for Reproductive Medicine, 2012. Web.
  • J.A. Abbott, J. Hawe, R.D. Clayton, R. Garry. “The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up.” Hum Reprod. 18(9):1922-7. Web. September 2003.
  • “What are the treatments for endometriosis?” National Institute of Child Health and Human Development. National Institutes of Health, U.S. Department of Health and Human Services, September 13 2013. Web.
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