Endometriosis and fertility: the statistics that may surprise you
It’s endometriosis awareness month
Endometriosis is, unfortunately, a common gynaecological problem.
It can cause crippling pain or no pain at all.
The severity of endometriosis can impact on your ability to conceive naturally. According to the National Endometriosis Society in the United Kingdom the chance of conceiving if you have mild to minimal endometriosis is not that different to a woman without endometriosis. The greater the severity of your endometriosis however the lower the chance you have of conceiving naturally.
As we’ve said in a previous blog, there is—as yet—no known cure for endometriosis. A common myth is that pregnancy will cure endometriosis, while this is untrue it has stemmed from the fact that pregnancy can supresses endometriosis symptoms. Once you’ve stopped breast feeding the symptoms will return.
The “Endometriosis, Fertility and Pregnancy” leaflet put out by Endometriosis UK states:
- If 100 women without endometriosis try for a baby at the end of the year 84 will be pregnant.
- If 100 women with minimal-mild endometriosis try for a baby at the end of the year 75 will be pregnant.
- If 100 women with moderate endometriosis all start trying for a baby at the end of year 50 will be pregnant.
- If 100 women with severe endometriosis start trying for a baby, at the end of the year 25 will be pregnant.
Endometriosis and infertility?
There are four stages to endometriosis:
- Stage i (minimal)
This stage is characterised by a superficial lesions and a few filmy adhesions.
2. Stage ii (mild)
In addition to the above, there are also some deep lesions present.
3. Stage iii (moderate)
Same as stage ii, with the addition of endometriomas on the ovary and extensive adhesions.
4. Stage iV (severe)
Same as stage iii, plus large endometriomas, extensive adhesion and nodular disease.
How endometriosis can cause infertility
Scar tissue distorts the pelvic anatomy, and if the ovary is wrapped in adhesions the egg gets trapped and is unable to reach the tube. If the Pouch of Douglas is covered in adhesions then the chance of fertility is also lower.
There are a few theories as to why mild to minimal endometriosis causes infertility:
- An abnormal immune response
- Failure of the egg sac to release its egg
- Toxins in peritoneal fluid (a naturally occurring fluid within the body cavity)
- Problems with the egg transport down the fallopian tube
Pregnancy and endometriosis
Endometriosis can delay getting pregnant however once you are pregnant it should not be any different than normal. What normally happens is that from pregnancy through to breast feeding the symptoms of endometriosis are supressed, which is where the myth that endometriosis can be cured by pregnancy comes from.
One of the biggest problems with endometriosis (as with many chronic, currently-incurable illnesses) is the emotional effects. Imagine being in too much pain to get out of bed. Essentially, the emotional effects of this can be just as crippling as the physical.
March is endometriosis awareness month
This chronic illness affects, on average, one in ten women. And on average, it takes eight years from presenting symptoms to diagnosis.
There needs to be more awareness about the symptoms of endometriosis. Ultrasound clinics like OMNI Ultrasound & Gynaecological have the diagnostic tools to diagnose endometriosis, but GPs and Obstetricians need to be cognisant of the symptoms of endometriosis so they can send women to get the tests they need.
Although no one knows the natural history of the disease, if endometriosis is not treated it can potentially worsen over time.
To find out more about OMNI Ultrasound & Gynaecological Care can help you, or to book a consultation at one of our Sydney clinics, please contact us.