The number of infertile couples today is a lot more than ever before. Why is infertility at an all-time high? This is a question that confounds researchers and the medical industry. Statistics state that one out of every 5 couples are unable to conceive and needs to seek medical assistance to conceive. These couples might be facing infertility due to some medical issues or the sedentary lifestyles that might prevent them from conceiving.
There are many issues that plague women and prevent them from conceiving naturally. There are a variety of treatment options to provide solutions for different kinds of fertility problems. The uterus is a very important organ when it comes to pregnancy. Any kind of problem with the uterus can hinder pregnancy or its ability to carry a baby to full term. And Endometriosis is a disease related to the uterus which can become painful and sometimes affect pregnancy.
Endometriosis is abnormal tissue growth and is a disease which is related to the uterus. In some cases, it can cause infertility by affecting the surrounding reproductive organs and impeding their ability to function normally.
When the tissue which makes up the uterine lining grows outside the uterus and onto the surrounding organs like the ovaries and the Fallopian tubes it is referred to as endometriosis. The endometrium tissue forms a lining inside the uterus after ovulation in preparation for implantation and pregnancy. If this tissue grows outside the uterus, then it is considered as a disease.
At times this tissue also grows onto other organs and hampers their proper functioning. When the endometriosis affects the functioning of other reproductive organs like the Fallopian tubes and the ovaries, it can affect fertility in a disastrous way.
One of the most common endometriosis symptoms is pelvic pain. This is a reoccurring pain and can vary from mild pain to severe pain. The pain occurs in the pelvic area, the lower back and even travels down the legs in some cases. The severity of the pain depends on the extent of the endometriosis. Some women also experience a cramping sensation in their pelvic region. The symptoms are summarised below:
The actual endometriosis causes is not known. However, possible reasons can be due to:
2-10% of women of the childbearing age are affected with endometriosis. The condition is painful, but if one understands the risk factors that might lead to this condition then it can be managed properly, and the woman can be sure enough if she is susceptible to the condition or not.
Endometriosis is a disease caused by the extra growth of tissue. A pelvic examination which is often conducted by doctors to check for cysts and abnormal growth in the reproductive organ does not reveal the endometriosis. In some cases, if cysts have developed due to endometriosis, it may be felt as an abnormality, and hence your doctor will suspect that there is some abnormality which needs further investigations through tests.
An ultrasound with a transducer pressed against your abdominal area as well as a transvaginal ultrasound probe together may give imaging of the reproductive organs but does not give a clear indication about the presence of endometriosis. If there are cysts on the endometriosis, they will show up on the ultrasound. The presence of cysts may lead to doctor’s suspect that there is an endometrial tissue growth outside the uterus.
Laparoscopy is the best and most definitive way of endometriosis diagnosis. It is a surgical procedure in which a camera (laparoscope) is inserted into the abdominal cavity through a small incision. This procedure is carried out while the patient is under anaesthesia. The doctors may also take a small tissue sample to conduct further tests. The laparoscopy procedure reveals information about the size of the endometriosis and the extent to which it has spread.
It is important to understand how much the endometriosis has spread and the areas or internal organs that it has affected if any. The endometriosis treatment is determined based on this vital information. The endometriosis can affect the normal working of the organs that it spreads to and lead to an organ shift in severe cases.
Most of the endometriosis cases are quite mild. Mild endometriosis usually does not show any symptoms and women have been able to successfully conceive and have a fertile reproductive life. Very rarely, a woman with a case of mild endometriosis has been found to be infertile. Infertility with mild endometriosis is defined as a case of unexplained infertility.
In conditions of severe endometriosis, it can affect the pelvic anatomy and distort it by displacing the organs or binding them together with the tissue growth. This causes some of the internal organs in the abdominal cavity to shift position. Severe endometriosis also causes pelvic scarring. In most cases of severe endometriosis, the fallopian tubes are badly affected and get blocked or severely damaged, causing infertility. The ovaries develop cysts due to the endometriosis and get attached to the uterus or the sidewall of the pelvic region.
Severe endometriosis can affect ovarian reserve and well as lead to the damage of the eggs. Many women with severe endometriosis have been found to have poor quality eggs, and a decreased ovarian reserve. In most cases, severe endometriosis results in infertility. Women with severe endometriosis will have to seek fertility treatment to conceive.
Medicover Fertility IVF Consultant says, “Endometriosis is not always easy to diagnose, and sometimes patients have no symptoms at all. Very often, infertility due to endometriosis is mistaken as a case of unexplained infertility. If the endometriosis is detected while it is in the milder stages, then treatment is easier. Doctors need to keep a lookout for endometriosis as it is not as uncommon as one thinks.”
Up to 10% of women have endometriosis, but among these women, only a certain percentage of them face problems with getting pregnant and infertility.
Endometriosis can sometimes cause fertility problems. Around 40% of the women with endometriosis are infertile and unable to conceive.
Infertility with endometriosis is caused by blockage of the Fallopian tubes due to the endometrial tissue over it or a malfunction of the ovaries due to the growth of the endometrial tissue. Sometimes endometriosis prevents implantation as well.
Some researchers believe that delayed pregnancy can lead to the development of endometriosis rather than it being the other way around and endometriosis causing infertility.
The treatment for endometriosis depends on the severity of the tissue growth and the regions it has spread to. For milder cases of endometriosis, a doctor may prescribe medication to retard the growth of the endometriosis. More severe cases where the endometriosis has covered other organs and is causing a problem, then the recommendation is surgery to remove the endometriosis growth. Most doctors prefer to keep surgery as a last resort.
The key to a successful endometriosis treatment is the individualisation of the patient’s care, based on their symptoms and accurate diagnosis. Once the state of endometriosis is known, the treatment involves either medical or surgical procedures or a combination of both, depending upon person-to-person.
Some of the treatment options recommended by doctors are:
A woman diagnosed with endometriosis might also suffer from infertility. According to research, 25 – 50% of the women suffering from infertility are affected with endometriosis. However, with the right treatment, the chances of getting pregnant with endometriosis can be considerably enhanced.
At first, the doctor surgically removes the endometrial tissues through laparoscopy, or other similar procedures, and then accordingly, the infertility treatment options are suggested to patients facing infertility. The treatment options vary from person-to-person depending upon the type of infertility and their level of endometriosis.
Some of the common treatments include:
Above all the endometriosis treatment procedures, IVF treatment, after removal of the endometrial tissues by laparoscopy or similar other procedures, is considered to be the best treatment of endometriosis, to conceive a pregnancy.
Women who are not able to get pregnant and have been diagnosed with endometriosis are usually advised to consider some form of Assisted Reproductive Technique to conceive. There are many different variations of IVF treatment, which can be used by women who have endometriosis to have a baby. IVF is the most popular type of assisted reproductive technique around the world.
The Assisted Reproductive Technique commonly prescribed for patients suffering from endometriosis is In vitro fertilisation. In this treatment, the female egg is made to fertilise with the male sperm in a petri dish, and this procedure takes place in a lab. An embryologist supervises the fertilisation of the egg and sperm. The egg is extracted from the female partner by giving her some hormonal injections to stimulate her ovaries to grow mature eggs. These eggs are then aspirated through a special egg retrieval process. The semen sample is given by the male partner and is required to produce on the same day as the egg retrieval.
Once the embryos have formed in the lab, they are kept in an incubator for 2 to 3 days and then transferred to the female partner’s uterus. The next stage after fertilisation is the transfer of the embryo to the uterus and wait for its implantation. The embryo has to hatch from its outer covering and embed itself in the endometrial lining inside the uterus which is known as implantation. Women with more severe cases of endometriosis may find it more difficult to conceive as the embryo does not implant easily. Fertility drugs are given to the patients to improve the chances of implantation and help the uterus to become receptive to the embryo.
In some cases, the embryo is kept in the lab till the blastocyst stage and then transferred on the 5th or 6th day. Doctors believe that blastocysts have a higher implantation success rate, and the uterus is more receptive on the 6th day than on the 3rd day.
Women who have undergone hysterectomy with their ovaries intact can have a child through a surrogate mother using their own eggs. Those women whose ovaries have also been removed can opt for donor egg IVF and then go with surrogacy where the donor egg is fertilised by the husband’s sperm and transferred to the uterus of the surrogate.
Medicover Fertility Clinic is one of the leading fertility clinics now in India. Medicover has state of the art infrastructure and lab facilities. We follow international standards in keeping with our European brand name. Medicover provides specialised patient care. We believe that each patient is unique, and each case is different, so the treatment plan is tailored according to individual patient needs.
At Medicover Fertility, fertility consultants are assigned to couples who can understand their case and work closely with them at each step throughout their fertility treatment. The couple can clear their doubts and present their queries to their attending consultants. Every couple needs to feel that they matter and we at Medicover Fertility exactly make them feel so so that they feel at home and are comfortable.
It is advisable to consult with a doctor rather than jumping to conclusions with a self-diagnosis. Pain in the pelvic area is one of the symptoms of endometriosis, but you could also have some other minor problem that is causing you pain.
The safest way to have a baby when you have endometriosis is through IVF.
You can conceive naturally even if you have endometriosis. 60% of the women with endometriosis are able to conceive naturally without any problem in their pregnancy. If you have a condition of infertility caused due to the endometriosis, then IVF is the best choice.
Although, endometriosis is usually asymptomatic; however, some of the common symptoms include, pelvic pain, pain before or during periods, infertility, pain during intercourse, abnormal bleeding, etc.
In the case of endometriosis, the endometrium grows outside the uterus. The misplaced tissue continues to thicken, shed and bleed with every menstrual cycle. Since the blood and tissues shed outside the body, do not find a way to flow out of the body, they lead to inflammation and pain.
Yes! It is generally believed that about 60 – 70% of the woman with endometriosis are fertile. Moreover, half of the women facing trouble conceiving, eventually become pregnant, with or without the treatment.
Endometriosis is usually a result of retrograde menstruation. Although the exact cause of endometriosis is unknown, it may also be caused due to genetic factors.