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Endometriosis & Pregnancy

Endometriosis is the growth of tissue that is normally found in the uterus in location outside of the uterine cavity, most commonly the ovaries, bowel, Fallopian tubes or bladder.

Estrogen is the hormone that causes your uterine lining to thicken each month. When estrogen levels drop, the lining is expelled from the uterus, resulting in menstrual flow(periods). But unlike the tissue lining the uterus, which leaves your body during menstruation,endometriosis tissue is trapped in the pelvic cavity. With no place to go, the tissue bleeds internally. Your body reacts to the internal bleeding with inflammation, a process that can lead to the formation of scar tissue, also called adhesions. This inflammation and the resulting scar tissue may cause pain and other symptoms. Recent research also finds that this misplaced endometrial tissue may develop its own blood supply to help it proliferate and nerve supply to communicate with the brain, one reason for the condition’s severe pain and the other chronic pain conditions so many women with endometriosis suffer from. (source: http://www.healthywomen.org)

Severe endometriosis with extensive scarring and organ damage may affect fertility. It is considered one of the three major causes of female infertility.

The symptoms of endometriosis include painful periods, painful ovulation, pain during or after sexual intercourse, abnormal bleeding, chronic pelvic pain, fatigue, and infertility, and can impact on general physical, mental, and social well being.

Can Endometriosis Interfere in Pregnancy?

Endometriosis can cause the fallopian tubes to become blocked and can damage the ovaries. It is estimated to be the cause of infertility in 3 per cent of couples, and is one of the factors behind tubal problems which cause infertility for about 17 per cent of couples.

However, evidence suggests even if your endometriosis is severe, you may still have a chance of getting pregnant naturally – it depends on how the disease has affected your reproductive organs. If you know you have endometriosis and you are having problems conceiving then you should seek help sooner rather than later. Don’t wait longer than six months of trying before making an appointment with your doctor.

How to get Pregnant with Endometriosis?

Not all women, especially those with mild endometriosis, will have infertility.

For those patients with mild or minimal endometriosis who wish to become pregnant, doctors are advising that, depending on the age of the patient and the amount of pain associated with the disease, the best course of action is to have a trial period of unprotected intercourse for six months to one year. If pregnancy does not occur within that time, then further treatment may be needed.

Laparoscopy (also called keyhole surgery, is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5–1.5 cm)) to remove scarring related to the condition may help improve your chances of becoming pregnant. If it does not, fertility treatments should be considered.

Discuss treatment options with your doctor to decide what would be the best course to take to increase your chances of pregnancy.

In one Australian study involving 3895 women with endometriosis, 54% of the women who tried to become pregnant did not succeed in the first 12 months of trying. However, 70% of them ended up having at least one child. (source: http://endometriosis.org/)

 

Endometriosis During Pregnancy

Pregnancy might lead to improvement in endometriosis symptoms, particularly during the latter months of pregnancy. However, some women experience a worsening of symptoms, particularly during the first three months.

It is believed that the beneficial effects are due to the high levels of progesterone produced during pregnancy. It is thought that the progesterone suppresses the growth and development of the endometriosis lesions, causing them to become less active. The effects may also be due to the lack of menstruation during pregnancy.

The reality is that pregnancy—like hormonal drug treatments—may temporarily suppress the symptoms of endometriosis but do not eradicate the disease itself. Therefore, symptoms usually recur after the birth of the child.

Reference

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