Many women who have been diagnosed with endometriosis or experienced its symptoms are not sure how this medical condition can affect their fertility. You may not even know you have endometriosis until you talk to your doctor about fertility problems.
Fortunately, women with endometriosis who want to grow their families have options, including IVF and gestational surrogacy.
What Is Endometriosis?
In women with endometriosis, the lining of the uterus or endometrium is enlarged and expands outside of the uterus itself. For instance, a patient with endometriosis might have a uterus lining that extends into the fallopian tubes or the ovaries.
The overgrown lining continues to perform its role. About once a month, the lining thickens and then sheds. But since the shedded lining does not have an outlet, the body must try accommodate, eventually leading to scarring and potentially cysts. Severe endometriosis can also force organs, muscles and other internal structures to adhere to one another.
Why Does Endometriosis Affect Pregnancy?
Women with mild endometriosis may have difficulty conceiving but can sometimes conceive and carry a child. Women who present severe endometriosis may not be able to support a child. With so much scar tissue and a displaced endometrial lining, the fertilized egg cannot attach to the lining and safely remain protected inside the uterus.
Many endometriosis patients experience ectopic pregnancies, or pregnancies that happen outside the uterus. These pregnancies have a greater than average chance of ending in miscarriage.
What Are Common Symptoms of Endometriosis?
Women who have endometriosis may experience symptoms that include:
- General pain and discomfort: Endometriosis causes inflammation and agitation in the uterine and pelvic region. Some women find the discomfort mild but not debilitating. Severe endometriosis can be so painful that women may need to take pain medication.
- Irregular bleeding: Menstrual bleeding is not always routine or predictable among women who have endometriosis. For instance, a woman with endometriosis may have heavy periods every week or so. Then, she might not bleed for a month or two.
- Fertility problems: Without a healthy uterine wall, women who try to conceive naturally may be unable to get or remain pregnant. After several miscarriages or trouble getting pregnant, a woman should consider seeing a specialist in women’s fertility to rule out endometriosis.
- Pain during sex: Another sign of endometriosis is pressure and pain in the pelvic and bowel region during sex. The pain usually stays the same or worsens during intercourse.
- Painful urination and elimination: Some women with endometriosis report being unable to go to the bathroom without pain, discomfort or forceful pressure.
Who Is Most at Risk for Developing Endometriosis?
Endometriosis is more common in women in their 30s or 40s who have never had children. Scientific studies have shown that women whose close family members have endometriosis are more prone to be diagnosed. But having a mother, grandmother, aunt or sisters with endometriosis does not guarantee that the condition will be passed down.
How Is Endometriosis Treated?
Endometriosis treatment depends on the individual patient. Women with endometriosis have many choices for dealing with both the symptoms of endometriosis and the condition itself.
After a pelvic examination and possibly an ultrasound or MRI, you can talk about the best treatment solutions with your physician, including:
- Pain medicines: Doctors may recommend either over-the-counter or prescription pain medications to alleviate discomfort and pressure. Anti-inflammatory medications can lessen the effects of menstruation-related cramping by making the uterus lining less thick during certain times of the month.
- Hormonal therapies: Some women find relief in hormone therapies, including birth control pills. It may be necessary to try a number of hormone combinations before discovering the perfect fit.
- Mild surgeries: Conservative surgical methods to remove some areas of endometriosis can be successful. They can even help women with fertility problems conceive and carry naturally, as long as the ovaries and uterus remain viable and intact after surgery.
- Hysterectomy: When endometriosis has reached extreme levels, the best response may be to perform a hysterectomy. During a hysterectomy, a surgeon may remove the uterus and possibly the ovaries.
Infertile women with endometriosis who want to become mothers have many options, including gestational surrogacy and IVF. At Western Fertility Institute, we will not stop working until your dream of growing your family comes true.
To talk with a member of our caring, compassionate team, contact Western Fertility Institute today.
This content was medically reviewed by the Western Fertility Institute medical team on October 21, 2019.