Fertility and Endometriosis

Most women with endometriosis are not infertile. So, if you don’t want to become pregnant, then reliable contraception is important.

Endometriosis can compromise fertility in some women, though the reason is not always clear.  There are some theories which help explain why.

It’s easy to understand how it might be a problem in women with moderate to severe endometriosis. In these cases the pelvic organs can become distorted making it hard for the tubes to pick up an egg from the ovary and transport it to the uterus.    Mild endometriosis can sometimes affect fertility as well. We now know that the endometrium (lining of the uterus) is different in women with endometriosis. These changes may prevent the embryo implanting in the uterus.

It appears that endometriosis releases substances that affect normal embryo development and decrease sperm movement. It is very likely to be worsened if the reproductive organs are damaged by endometriosis and adhesions.

The shock of infertility is distressing. As well as the pain of endometriosis, there is the disappointment as each period arrives. There may be a feeling of guilt at letting everyone down and stress about fertility is hard on relationships.

Of course, there may be other reasons why a couple may not achieve a pregnancy.  There are lots of things which affect fertility on both sides. Age, whether either of you smoke and whether either of you are overweight significantly affect fertility.  Sperm quality and whether a woman ovulates each month and whether her fallopian tubes are open are factors affecting fertility.   Tests are usually recommended before any treatments begin to identify the problems.  Couples can improve their own fertility dramatically. STOP SMOKING. REDUCE WEIGHT TO A LOW BMI, EAT HEALTHILY, AVOID ALCOHOL.

There are fertility treatments available which have very positive outcomes. These should be discussed with you and will depend on lots of factors (age, smoking, weight, how long you’ve been trying and so on). Options include:

• Surgery to remove (excise) the endometriosis and restore the anatomy back to normal improves the chances of becoming pregnant by about 40%. This surgery is best performed by a specialist gynaecologist with advanced laparoscopic skills. The first 6 – 12 months following surgery seem to be a particularly fertile time.

• Treatments such as IVF. This is where the egg is fertilized by the sperm in a laboratory and then placed in the uterus.

Medications for endometriosis do not improve fertility. They also take up valuable time because you can’t get pregnant while you are taking them.

Find out more about fertility in women and men in the book “Endometriosis and Pelvic Pain” Evans / Bush

Click here for your Fertility check list.

These websites will offer more information:

• http://www.fertilityassociates.co.nz/
• http://www.repromed.co.nz/site/christchurch.aspx
• www.naturalfertility.co.nz    
• www.endometriosis.org