Pregnancy with endometriosis: possible fertility treatments

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Endometriosis is a very common disease in women of reproductive age and, moreover, is linked to fertility problems.

Approximately, between 30% and 50% of patients with endometriosis present sterility or have some problem to achieve natural pregnancy.

Assisted reproduction has greatly helped these women achieve a pregnancy with endometriosis, especially techniques such as in vitro fertilization (IVF) and oocyte donation.

Below you have an index with all the points that we will discuss in this article.

Index

Pregnancy with endometriosis: possible fertility treatments

Causes of sterility due to endometriosis

Although the causes of endometriosis are still a little confusing, to this day there are already several studies that explain why endometriosis affects fertility. Next, we discuss the main causes:



Anatomical causes

The ovaries and fallopian tubes are affected mainly by the growth of endometrial tissue outside the uterus.

In the ovary, the endometrial adhesions destroy healthy tissue, which affects the ovarian reserve, hinders the normal development of the follicles and the maturation of the oocytes. In addition, these endometrial cysts can also prevent ovulation.

When endometriosis appears in the uterine tubes, it interferes with tubal patency. This prevents the passage and transport of the ovum through the tube when it is released from the ovary, so it does not fertilize or reach the uterus.

Tubaric obstruction due to endometriosis

Apart from the permeability of the fallopian tubes, these may have another difficulty due to the increase in the volume of the peritoneal fluid and the presence of inhibitors of the oocyte capture. The consequence of this is that the fimbrias of the tube can not interact with the ovule and it can not reach the tube after ovulation.



Decreased endometrial receptivity

Sterility can also be due to alterations of the immune system: IgG and IgA antibodies, like lymphocytes, are increased in blood, which can affect endometrial receptivity and embryo implantation.

The implantation capacity of the embryo may also be diminished because patients with endometriosis have problems to synthesize endometrial ligament and, in addition, the levels of integrins (cellular adhesion molecules for implantation) are very low.

Finally, endometrial lesions or endometriomas can secrete toxic substances that affect both the egg and the sperm.

If you want more information about this disease, you can visit the following specialized page: www.laendometriosis.com

Endometriosis and natural pregnancy

The first option for women with endometriosis to recover fertility and can have children with a natural pregnancy is medical and / or surgical treatment, depending on the degree of involvement and the medical history of each patient.

In endometriosis, 4 degrees can be differentiated according to the location, quantity, depth and size of endometrial implants:

  • Grade I or minimum grade.
  • Grade II or mild grade.
  • Grade III or moderate degree.
  • Grade IV or severe grade.

Analgesics and hormonal treatments are effective in relieving pain and regulating menstrual cycles. However, it will be necessary to perform laparoscopic surgery to improve fertility and increase the probability of pregnancy.

Above all, they are effective treatments in mild endometriosis for a natural pregnancy.

Laparoscopic surgery is a minimally invasive technique in which a laparoscope is inserted to observe the abdominal cavity through a small incision.

In the most severe cases of endometriosis, when women have endometriomas or ovarian cysts, also called chocolate cysts, it is advisable to perform a laparoscopic cystectomy to remove these cysts. It has been shown that this can increase the pregnancy rate.

Pregnancy with endometriosis is possible

Endometriosis and fertility treatment

If the pregnancy does not arrive after a surgery and after having been at least one year trying, the techniques of assisted reproduction are a hope for those women who see their maternity leave.

Depending on the severity of the endometriosis and the evolution of the treatments, the appropriate techniques will be one or the other:

Artificial insemination

Artificial insemination (AI) is indicated for young patients with mild endometriosis (grade I and II).

The hormones used for ovarian stimulation improve the prognosis of these women. Obviously, for the AI ??to be effective, it will be necessary that the tubes are not obstructed and the interaction of the sperm with the ovum is allowed.

In vitro fertilization

IVF is the technique of choice for patients with greater type III or IV involvement, and also when the AI ??has failed in women who had a better prognosis.

This method offers a higher gestation rate in women with endometriosis than if an AI is performed. However, specialists recommend trying a first insemination in women who meet the requirements due to the simplicity of the technique.

If you want to get a cheaper price for the AI ??or the IVF, in our Discounts Section you have access to the download of coupons where, in addition, you will find a free first visit in one of the clinics with which we have an agreement.

Get more information at the following links:

  • See discounts on AI
  • See discounts on IVF / ICSI

Ovodonation

In the IVF laboratory it has been observed that, both the ovules and the embryos of patients with endometriosis, have a worse morphology. In addition, fecundation and the subsequent development of the embryo have also been affected.

Therefore, women with severe endometriosis and / or several failed IVF cycles are forced to resort to oocyte donation as the last option to have children. In fact, 10% of donor egg recipients are patients with endometriosis.

With the ovules of a healthy young donor without morphological alterations, the pregnancy rates of patients with endometriosis are similar to those of a woman without this condition.

In inviTRA we can help you find a clinic with the best price for this treatment. For this, you can access the following link calculator custom budgets.

Oocyte donation is also indicated in cases where endometriomas of the ovary prevent follicular puncture to recover the ovules.

Preservation of fertility

Since endometriosis is a progressive disease and a woman's age also aggravates the infertility situation, women diagnosed with endometriosis are recommended to vitrify their ovules if they wish to have children in the future.

In this way, the quality of the ovules is not reduced so that IVF treatment is more successful. In addition, we must remember that the ovarian reserve is also affected with endometriosis.

Questions from users

What are the risks in a pregnancy with endometriosis?

Women with endometriosis have a higher risk of having early complications in pregnancy. These complications are spontaneous abortion and ectopic pregnancy. There is also a higher incidence of premature birth and cesarean delivery.

Even if it is not considered a high-risk pregnancy, these women should be more careful and vigilant to avoid problems during pregnancy.

Does endometriosis improve with pregnancy?

Indeed, pregnancy has a protective effect of endometriosis. This is due to the arrest of the menstrual cycle of women and the decrease of estrogens, hormones involved in the growth of endometriomas. Therefore, during pregnancy, the woman feels relief in the symptoms and pain. Unfortunately, all this resumes once the woman has given birth.

Is it possible to get a pregnancy at 40 if I have endometriosis?

In principle yes, but you should assess the degree of endometriosis to see what would be the indicated technique.

With 40 years, the AI ??has very little chance of success. It is best to resort to an IVF whenever it is possible to perform a follicular puncture. If, in addition, endometriosis is very advanced, it would be necessary to resort to an egg donor to achieve pregnancy.

Recommended reading

In addition to sterility, endometriosis can present other symptoms such as pain. In the following post you will find more information about this: Symptoms of endometriosis.

The ovarian reserve may be affected as a result of endometriosis in the ovary. To know how this affects the fertility of women, click here: What is the ovarian reserve?

We have talked about the preservation of fertility as a method to prevent the deterioration of oocyte quality. If you want to know what this method consists of and the prices you have in Spain, you can continue reading here: Preservation of fertility.

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