Endometriosis is the condition where the lining of the uterus, called the endometrium, grows outside the uterus and in other places, such as the fallopian tubes, ovaries or alongthe pelvis. When this lining breaks down, similar to the regular lining in the uterus (menstruation), it has no place to go hence causes cysts, heavy periods, severe cramps and even infertility in some cases.
Infertility is defined as the inability to conceive a child. Fertility problems are highly associated with endometriosis. While endometriosis does not directly cause infertility, fertility problems are highly associated with endometriosis, i.e., patients who have the disease will have a significantly lower chance of getting pregnant.
When a woman has endometriosis, the normal functioning of the reproductive organs are hindered by the endometrial growth of the tissue. If it affects the ovaries, it restricts the release of eggs. And when it affects the fallopian tube, it prevents the sperm from reaching the egg and also stops the fertilized egg from travelling to the uterus. Such obstacles prevent pregnancy or can cause very complicated pregnancies, including miscarriages. Some of the factors leading to reduced fertility in endometriosis are as follows:
- Impaired uterotubal transport of sperm
- Ovulatory disturbances
- Subtle impairment of oocyte and embryo quality
- Implantation defects
- Anti-endometrial antibodies
- Progesterone resistance
- Increased risk of recurrent miscarriage
Management of Endometriosis- Associated Infertility
As challenging as Endometriosis sounds, experts from Fertility Hospital in Chennai suggest that IVF treatment are helpful in providing desired results especially in advanced diseases. According to a recent survey, one-third of women who have endometriosis can conceive naturally without any treatment but for the remaining, IVF emerges as the best solution.
Stage I/II endometriosis-associated infertility
For younger patients who are less than 35 years either expectant management or superovulation with or without IUI can be offered after laparoscopy. For women of 35 years of age or older, superovulation with IUI or IVF should be done.
Stage III/IV endometriosis-associated infertility
IVF should be offered to these patients. There is supporting evidence, which suggests that ultra-long protocol in severe endometriosis increases the clinical pregnancy rates. However, a meta-analysis by Harb et al. showed that in women with severe endometriosis (stage III/IV) undergoing IVF treatment, the implantation rates and clinical pregnancy rates are severely affected.
Bloom Chennai is a specialized Centre for Woman & Child Wellness and comes under one of the best IVF Hospitals in Chennai. Bloom has also paved its way as one of the leading Fibroid hospitals in Chennai. At Bloom we strive to provide 360 degree healthcare solutions ensuring people lead a happy, healthy life. In case of concern or further query, you can always consult us and get answers to your questions.
