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Endometriosis & Fertility: Is It Possible To Still Get Pregnant?

If you have endometriosis, pregnancy can present a unique set of challenges.

From managing symptoms to ensuring a healthy pregnancy, there’s much to consider throughout a fertility journey, and endometriosis can add its share of complications. But that doesn’t mean pregnancy is impossible!

Whether you’re planning for pregnancy, currently expecting, or supporting a loved one, there is new information all the time about how to have a healthy and successful experience. We’re here to guide you through the joys and complexities of pregnancy while living with endometriosis.

What’s important to know about endometriosis

Endometriosis is complex and often misunderstood, and it can have significant implications for fertility. It occurs when tissue similar to the lining of the uterus, called endometrium, grows outside the uterus, commonly on the ovaries, fallopian tubes, and surrounding pelvic organs.

While endometriosis affects approximately 10% of women of reproductive age, its impact on fertility can be profound and sometimes distressing.

Understanding the relationship between endometriosis and fertility is essential for couples trying to conceive, but the severity of endometriosis does not always go hand-in-hand with its effect on fertility. Some women with minimal endometriosis may experience more difficulties conceiving, while others with advanced stages may conceive naturally. Everyone is different, and every case should be handled with care and patience.

A multidisciplinary approach and a personalised strategy involving gynaecologists, reproductive endocrinologists, and fertility specialists can provide comprehensive care. It can address both fertility concerns and pain management, as well as the overall preservation of your reproductive health.

There are many ways endometriosis can affect fertility

While everyone will have their own set of risks and concerns, there are some major possibilities to bear in mind and to be on the lookout for when trying to become pregnant.

#1: Pelvic Inflammation: Endometriosis can lead to inflammation in the pelvic cavity, disrupting normal reproductive processes and hindering fertility.

#2: Adhesion Formation: The presence of endometrial tissue outside the uterus can result in the formation of adhesions, or scar tissue, which may distort pelvic anatomy and interfere with the fallopian tubes’ ability to pick up eggs released by the ovaries.

#3: Ovulatory Dysfunction: Endometriosis can disrupt the normal function of the ovaries, potentially causing irregular ovulation or inhibiting ovulation altogether, which can reduce the chances of conception.

#4: Hormonal Imbalances: Endometriosis is associated with alterations in hormonal regulation, including increased levels of oestrogen and decreased progesterone levels, which can adversely affect the menstrual cycle and impair fertility.

#5: Endometrial Receptivity: Endometriosis may impair the lining of the uterus (endometrium), affecting its ability to support embryo implantation and subsequent pregnancy.

#6: Reduced Egg Quality: The inflammatory environment associated with endometriosis can compromise egg quality, making it more difficult for fertilisation to occur and increasing the likelihood of miscarriage if conception does happen.

#7: Tubal Dysfunction: Endometriosis can affect the function of the fallopian tubes, leading to blockages or inflammation that impede the passage of sperm or the transport of embryos, thereby reducing fertility.

#8: Immune System Dysfunction: Endometriosis can alter the immune system’s response, potentially leading to an immune reaction against sperm, or embryos, which can impact upon sperm penetrating the egg and implantation success.

In addition to the above concerns, chronic pelvic pain is a common symptom of endometriosis.

Pelvic pain can negatively impact sexual intercourse and overall reproductive health, leading to decreased frequency of intercourse and reduced chances of conception. Sometimes surgery to remove endometrial lesions and adhesions can improve fertility, but it could also cause scarring or damage to reproductive organs, affecting fertility outcomes.

These are, of course, not applicable to every case, which is why consulting with your physician is an absolute must. Be sure to document any symptoms or pain you may be experiencing and talk with your doctor about how these concerns might affect a pregnancy.

Managing endometriosis can be a balancing act

Women with endometriosis can take several steps to maintain healthy reproductive function despite the challenges. Both home remedies and professional medical help can manage a variety of symptoms and struggles.

What are some management techniques I can use at home?

#1: Start by monitoring your cycle: Regular monitoring of menstrual cycles and symptoms can help you track any changes or worsening of endometriosis-related symptoms. This allows for timely intervention and management.

#2: Consider a few lifestyle modifications: Adopting a healthy lifestyle can support reproductive function and overall health. This includes maintaining a balanced diet, regular exercise, stress management techniques, and adequate sleep.

#3: Be sure you have plenty of emotional support: Coping with the challenges of endometriosis can be emotionally taxing. Seeking support from loved ones, joining support groups, or seeking counselling can help manage stress and promote emotional well-being.

What are some ways medical professionals can help?

Medical professionals can help you with a pain management plan. Managing pain associated with endometriosis is a major component of maintaining overall well-being and reproductive function. This may involve over-the-counter pain relievers, prescription medications, heat therapy, acupuncture, or other complementary therapies.

Hormonal therapy might be worth considering. While it may seem contrary to the goal of becoming pregnant, hormonal therapy, such as birth control pills, hormonal IUDs, or GnRH agonists, can actually help to regulate menstrual cycles, reduce pain, and potentially slow the progression of endometriosis. These treatments may also preserve fertility in some cases.

Talk with a doctor about fertility preservation. For women concerned about future fertility, fertility preservation options such as egg freezing may be considered, especially if undergoing surgical interventions that could impact ovarian function.

“But just because you have endometriosis, doesn’t automatically mean you have infertility,” says Dr. Divya Kelath Shah, MD, MME.

Some women with endometriosis can benefit from surgical intervention. In cases where endometriosis is severe or causing significant symptoms, surgical interventions such as laparoscopic excision of endometrial lesions or adhesions may be necessary. These surgeries can improve pain symptoms and, in some cases, enhance fertility outcomes.

Fertility treatments are also an option for women trying to conceive. Assisted reproductive technologies (ART), including in vitro fertilisation (IVF) and intrauterine insemination (IUI), may be options for women struggling with infertility due to endometriosis. Consulting with a fertility specialist can help explore these options and develop a personalised treatment plan.

Women with endometriosis can optimise their reproductive health and overall quality of life by taking proactive steps to manage symptoms, seeking appropriate medical care, and making lifestyle adjustments where needed.

What else should I know about trying to conceive with endometriosis?

Managing endometriosis prior to pregnancy is only half the journey. Women with endometriosis should be aware of the following considerations when trying to conceive:

#1: Timing is essential: Understanding the menstrual cycle and identifying the most fertile window can maximise the chances of conception. Tracking basal body temperature, cervical mucus changes, and using ovulation predictor kits can help pinpoint ovulation.

#2: You need to maintain your sexual health: If you go down an assisted fertility route you may have tests to check whether you have any underlying sexually transmitted infections (STIs), and any sexual dysfunction that may impact conception.

#3: Remember to be persistent and that it can take time: Conceiving with endometriosis may take longer than expected, and setbacks may occur. Maintain open communication with your healthcare providers throughout the journey.

What else do I need to know?

Trying to conceive with endometriosis can be emotionally challenging. It’s important to prioritise emotional well-being and seek support from loved ones, support groups, or mental health professionals as needed.

Looking into alternative paths to parenthood is helpful, too. For some individuals with endometriosis, conceiving may not be possible through traditional means. Exploring alternative paths to parenthood such as adoption or surrogacy can provide alternative avenues to realise the dream of having a family.

It’s also important to advocate for your self-care. Taking time for relaxation, hobbies, and activities that bring joy and fulfilment, can help to manage the stress and maintain your physical and emotional well-being during the conception journey.

Optimism for the future

Staying informed, seeking appropriate medical guidance, and prioritising both physical and emotional well-being are some of the best things women with endometriosis can do to navigate the journey of fertility with resilience and hope.

Throughout the process, no matter what it may look like for you, remember to be gentle with yourself. Celebrate the small victories, acknowledge the challenges, and embrace the moments of joy and connection that arise.

Remember to prioritise your needs, lean on your support network, and advocate for yourself and your health.

Whether your path leads to conception, other forms of parenthood, or if your journey takes a different route completely, know that you are not alone, your experiences are important, and your story is always worth celebrating.

This article has been reviewed by our Kari Health Experts and Editorial Board to ensure accuracy and reliability of the information presented. However, please note that the content provided is for informational purposes only and should not replace advice from your medical professional.

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