Endometriosis, Fertility, and Pregnancy

Endometriosis is a common condition, but it comes with its complexities. So before we dive in, let’s take a look at some general information on this topic. 

Key takeaways:

  • While many women with endometriosis go on to have healthy pregnancies, it is one of the most common causes of infertility. 30 - 50% of women with this diagnosis may experience infertility. 
  • There are signs and symptoms that may indicate endometriosis, but the only way to establish a clear diagnosis is to undergo a laparoscopy (surgical procedure).
  • It’s important to talk to your OB/GYN if you are experiencing pelvic pain or abdominal pain, especially if the pain occurs with sex, bowel movements, or is around the same time as your menstrual bleeding.

The basics: what is endometriosis and how is it diagnosed?  

Endometriosis is a common condition in which endometrial-like tissue (the tissue that lines the uterus) is found outside of the uterus, in places like the ovaries, fallopian tubes, intestines, and bladder. 

While many women have no symptoms, only mild discomfort, others have pain that is severe and can prevent them from doing normal activities. If you are experiencing pelvic pain, or pain with menstruation, sex, or with bowel movements, make sure you discuss this in depth with your provider, who may perform a pelvic examination. The only way to diagnose endometriosis is to undergo a procedure called a laparoscopy. A laparoscopy is a procedure that a surgeon will perform to view someone’s abdominal organs. The amount of endometriosis that is seen at the time of laparoscopy is linked to future fertility, and in some cases, removal of the scar tissue can greatly improve one’s chances of successful pregnancy. 

How does this impact my reproductive health and fertility?  

Endometriosis can influence reproductive health and fertility in some of the following ways:

  • Change the anatomy of the pelvis and/or cause pelvic structural inflammation
  • Lead to scarring of the fallopian tubes, impacting egg movement through the tubes
  • Cause a buildup of scar tissue, also known as adhesions
  • Change the hormonal environment of the eggs and altered egg quality
  • Impact successful Implantation 

Due to the impact that endometriosis can have on the body, it is one of the most common conditions associated with infertility. However mild to moderate cases of endometriosis may only cause temporary infertility, and it’s important to note that many women with endometriosis go on to have healthy successful pregnancies.

Can I still get pregnant if I have endometriosis? What are my options?  

Yes, you can still get pregnant, and many women with this diagnosis do! Treatment of endometriosis may be medical, surgical or a combination of the two. A combination of both medical and surgical interventions may be beneficial to you if you are trying to conceive through IVF. Endometriosis treatment is very individualized because everyone's body is different, so it’s important to work with your provider(s) to figure out what the best plan of action is for you.

Treatments for endometriosis broken down: 

  • Hormone therapy: Hormone therapy is used to treat endometriosis associated pain. Your healthcare provider may suggest hormone treatments such as Gonadotropin-releasing hormones (GnRH), birth control, or progesterone. Each of these treatments impact ovulation and/or menstrual bleeding. They all come with common side effects, so it is important to dive into these options in depth with your provider. 
  • Pain medications: Over the counter pain relievers can improve pain associated with mild cases of endometriosis. The common pain relievers used are nonsteroidal anti-inflammatories (NSAIDS) such as Ibuprofen or Naproxen. Again, you’ll want to talk with your provider about these options for pain relief. 
  • Surgical treatments: If endometriosis is seen during a laparoscopy, your doctor will likely remove the scar tissue. This treatment can often restore anatomy that may be altered due to the endometriosis tissue, which allows reproductive organs to function normally. This could increase chances of pregnancy. Furthermore, research shows that surgical treatments can provide significant, short term, relief from endometriosis related pain. It is important to understand the surgical options in depth, especially because some procedures can not be reversed and may affect a woman's fertility. In more severe cases of endometriosis, where childbearing is not an issue or consideration, a hysterectomy may be performed.

In summary, many healthcare providers will recommend a laparoscopy and surgical treatment to improve fertility in women who have mild or minimal endometriosis. If pregnancy does not occur after these interventions, in vitro fertilization (IVF) or fertility preservation may help women become pregnant. Understanding your condition and its impact on fertility and treatment options is critical. That is where Frame comes in!

How can Frame help me?

Here at Frame, our Coaches will support you through your diagnosis or can help you uncover signs and symptoms you may be experiencing that could indicate endometriosis. Endometriosis is not a visible illness and it can be hard to understand not only from a physical standpoint, but also it can be challenging to process mentally and emotionally. We are here to support you holistically as we guide you through your options, prepare you for discussions with your provider(s), and educate on the benefits of being proactive, especially as you consider your family building goals. 

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