Yes, you can get pregnant with endometriosis – here’s how

Endometriosis affects one in 10 individuals of reproductive age, approximately 200 million people worldwide.

While 30% to 50% of those with endometriosis struggle with infertility, that doesn’t necessarily mean you should give up hope.

“Many women, including myself, have become pregnant with endometriosis,” says Janelle Luk, MD, FACOG, Medical Director of Generation Next Fertility. “Endometriosis doesn’t mean you can’t get pregnant on your own, however, it can increase your chances of infertility.

If you have endometriosis and are interested in starting a family, here are some helpful steps you and your partner can take.

What is endometriosis?

Let’s start with the basics. Endometriosis is when endometrial-like tissue, also known as implants, grows outside the uterus causing chronic inflammation, scar tissue, and adhesions.

“Endometriosis is a highly variable disease from mild to severe presentation,” says Fahimeh Sasan, MD, founding physician and obstetrician-gynecologist at Kindbody. “Depending on the severity of the disease and the extent of pelvic and abdominal organ involvement, the level of pain varies from woman to woman.”

It is also important to note that the amount of pain you feel is not necessarily related to the severity of the condition. Here are the four stages of endometriosis that describe the severity of a patient’s condition:

• Stage I. endometriosis. Stage I endometriosis is considered “minimal”. During this phase, the implants are small, shallow and limited in number.
• Stage II endometriosis. Stage II endometriosis is considered “mild”. During this stage, doctors can find more implants that are deeper than the implants found in stage I patients.
• Stage III endometriosis. Stage III endometriosis is considered “moderate”. During this stage, patients can experience a combination of deep implants and endometrial cysts on one ovary. Stage III patients may also have filmy adhesions or thin bands of tissue that have bound their organs together.
• Stage IV endometriosis. Stage IV endometriosis is considered “severe”. During this stage, patients will have deep implants, large cysts, and several dense adhesions throughout the pelvic region.

Endometriosis is persistent and can cause tissue to grow where it doesn’t belong, including the intestines, rectum, and bladder. The most common sites of endometriosis include:

• Ovaries
• fallopian tubes
• Ligaments that support the uterus
• Posterior cul-de-sac (i.e. the space between the uterus and rectum)
• Anterior cul-de-sac (i.e. the space between the uterus and the bladder)
• The lining of the pelvic cavity

Since every woman’s body is different, not all people will experience the same symptoms. In fact, 20% -25% of women with endometriosis are asymptomatic. Some of the common symptoms of endometriosis include:

• Debilitating pain in the lower back or abdomen
• Abnormal or heavy menstrual flow
• Pain during intercourse
• Pain with urination during menstrual periods
• Pain with bowel movements during menstrual periods
• Pain in the leg
• Chronic fatigue
• Gastrointestinal problems, such as constipation, diarrhea and nausea

Can You Get Pregnant With Endometriosis?

Endometriosis is considered to be one of the three main causes of female infertility – even so, it is not impossible for a woman with endometriosis to get pregnant.

“It’s definitely possible to get pregnant with endometriosis,” says Barry Witt, MD, Director of WINFertility and Greenwich Fertility & IVF Center. “Some will conceive without problems, while others will require treatment to conceive.”

Natural pregnancy occurs when an egg travels from the ovary, past the fallopian tube and to the uterus for fertilization before implanting itself in the uterine lining.

How endometriosis affects fertility is unclear, but researchers believe scar tissue has a lot to do with it.

“Some severe cases of endometriosis cause significant scarring around the ovaries and fallopian tubes – this can block the tubes or make it difficult for them to function normally,” Witt tells Insider. “Multiple surgeries for endometriosis can be associated with scarring and can affect ovarian function.”

Endometriosis can also damage a woman’s egg or a man’s sperm, ultimately preventing pregnancy.

Laparoscopy is the only way to confirm a diagnosis of endometriosis. Pregnancy can still occur, depending on the severity of the endometriosis found at the time of laparoscopy. According to Brigham Women’s Hospital, pregnancy rates can improve if stage I or II endometriosis is surgically removed.

“I was diagnosed with stage IV endometriosis and lost both of my fallopian tubes,” says Melissa Randazzo, a mother of two who has endometriosis. “After two cycles of in vitro fertilization, I managed to get pregnant with my first little miracle, Gaspare”. She later gave birth to her daughter, Lucy.

How to get pregnant with endometriosis

If you have endometriosis and are interested in starting a family, it may be helpful to speak to your endometriosis specialist or gynecologist first. This is especially true for women who have undergone multiple endometriosis surgeries.

“Women with endometriosis who are trying to conceive should see a reproductive endocrinologist,” says Witt. “A fertility specialist can evaluate a woman’s individual case based on her symptoms, ultrasound findings, age and other fertility factors in order to determine the best course of treatment.”

A reproductive endocrinologist may also perform blood tests, such as an anti-Müllerian hormone (AMH) test. This test can help determine a patient’s ovarian reserve or remaining ovarian reserve.

Endometriosis isn’t a one-size-fits-all condition, but taking the time to talk to your doctor, limit your intake of inflammatory foods, and engage in moderate physical activity can increase your chances of natural conception.

If after six months you and your partner are unable to conceive naturally, you may want to consider an endometriosis-related infertility treatment option, such as those listed below.

Superovulation and intrauterine insemination (SO-IUI)

Superovulation and intrauterine insemination (SO-IUI) is a viable option for women who have normal fallopian tubes.

SO-IUI is a two-step process that combines injectable or oral fertility drugs and sperm insemination.

Once the patient’s follicles are ready for ovulation, her partner will be asked to provide a fresh semen sample to the doctor or clinic. This sample is then prepared, “washed” and inserted into the woman’s uterus via a catheter. In some cases, this sample can be provided by a donor.

In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is a complex combination of procedures used to help with fertility. An in vitro fertilization cycle involves five steps:

• Ovarian stimulation. If you are using your own eggs, your doctor may recommend that you take a variety of medications, including synthetic hormones to stimulate the ovaries, one or more medications to prevent premature ovulation, and progesterone supplements to prepare the womb lining for the ovaries. plant.
• Recovery of the eggs. To determine if the eggs are ready for collection, the doctor will perform a vaginal ultrasound and a blood test. Once cleared for recovery, patients are sedated and undergo a transvaginal ultrasound. During the ultrasound, a fine needle is inserted into an ultrasound guide – this needle is inserted into the follicles to retrieve the eggs. The eggs are then removed from the follicles. Ripe eggs are collected and placed in a nutrient liquid and incubated.
• Sperm recovery. If you use your partner’s sperm, he or she will need to provide a semen sample by masturbation on the morning of the egg retrieval. Sperm from a donor can also be used.
• Fertilization. Fertilization can occur in two ways: conventional insemination or intracytoplasmic sperm injection (ICSI). During conventional insemination, healthy sperm and mature eggs are combined in a petri dish and incubated overnight. ICSI involves the injection of a single healthy sperm into each mature egg.
• Transfer of embryos. Two to five days after the egg retrieval, you will go through the embryo transfer process. During this procedure, the doctor will insert a catheter into the vagina, through the cervix and into the uterus. Using a syringe, the doctor inserts one or more embryos into the uterus. If successful, implantation will take place six to ten days after the egg retrieval.

“If there is tubal involvement, such as a blocked tube or scarring in the tube, IVF is the generally recommended treatment, because with IVF you can completely bypass the tubes,” says Dori Gelfman, RN, a specialist in the infertility and Community Manager of Fruitful Fertility. “By retrieving the eggs from the ovaries, fertilizing them and placing them directly into the uterus, you have created a detour where the tubes are no longer needed.”

Although most women with endometriosis who get pregnant have normal pregnancies and deliveries, women with endometriosis have a higher risk of:

Although temporary, some women with endometriosis may experience pregnancy relief due to an increase in progesterone.

“Pregnancy can actually alleviate some of the symptoms experienced for endometriosis patients,” says Luk. “For about nine months, the patient may experience minimal pain related to endometriosis.”

Insider’s takeaway

Women with endometriosis can get pregnant either naturally or with the help of fertility treatments, depending on the severity of their condition, age, and overall health.

Endometriosis is an intrusive, incurable and chronic disease. In addition to causing debilitating pain, endometriosis can affect mental health, social relationships, and sexual functioning.

“Lack of work and school are not uncommon in women with endometriosis,” says Fernando Mariz, MD, a gynecologist and obstetrician in New York City. “Between swelling, pain and general discomfort, completing normal activities can be next to impossible.”

If you have endometriosis, being proactive and defending your reproductive health is the key to a healthy pregnancy. This can include lifestyle changes or consulting a fertility specialist about medical interventions.

“I recommend that you stand up for yourself and be proactive with any treatment you need while you are still young, even before you consider becoming pregnant,” Luk tells Insider.