Friday, August 16, 2024

Endometriosis causes Infertility up to 50% among Women!!

Endometriosis effects 1 in every 10 people 

Endometriosis causes infertility in 30-50% of women

Women aged above 35 years are at greater risk of infertility as well as miscarriage

Laparoscopy surgery helps restore the normal reproductive functions

 

Endometriosis is a painful gynaecological condition affecting over 190  ( 19 crores) million girls and women globally. India alone represents 25 percent of the burden with an estimated 43 million ( 4.5 crores) women enduring the pain  suffering from Endometriosis which is a leading cause of infertility as well says Dr Vimee Bindra, Robotic and Laparosocpic Surgeon, Fertility Enhancing Surgery Specialist; Endometriosis Excision Surgery Specialist;  founder of Endometriosis Foundation of India

 

Approximately one-third of the women suffering from endometriosis can face some difficulty in conceiving. However, there are many others too with mild endometriosis who do not face any issues with fertility. These issues are more likely to develop as a woman moves towards a severe endometriosis case.

 

For a woman to become pregnant, her ovary must release an egg and that must travel through the fallopian tube. The egg is then fertilised with a sperm and attached itself to the wall of the uterus to begin the development of the foetus. In Endometriosis, the fallopian tubes may be blocked or damaged which prevent the sperm and the egg to come together. In some cases, endometriosis can damage the egg in the ovaries that may lead to lowered ovarian reserve and even low egg quality and quantity.

 

How do I know if I have endometriosis?

 

Endometriosis may present as painful periods, pelvic, abdominal pain, irregular bleeding, painful sex and infertility or it may be asymptomatic in some cases. As it involves the pelvic organs and pelvic peritoneum, it causes infertility in 30-50% of women. For some women there may be a formation of an ovarian cyst called as chocolate cyst which can be picked up on ultrasound. A good clinical history and examination are the key to diagnose endometriosis and then comes the role of imaging and laparoscopy. 


Common symptoms of endometriosis are 

 

Very painful menstrual cramps 

Chronic pelvic pain, backache

Painful sex

Painful defecation/urination 

Bleeding or spotting 

Infertility 

Stomach /digestive problems simulating idiopathic Bowel Syndrome (IBS) 

Diarrhea and constipation

Fatigue

Depression 

 

How endometriosis causes infertility?

 

Endometriosis impacts fertility by various mechanisms such as 

 

It distorts the pelvic anatomy

Adhesions 

Scarring 

Tubal damage 

Inflammation of pelvic organs 

Affects the egg quality 

Interferes with implantation 

Changes the hormonal milieu 

 

Different treatment modalities for endometriosis related infertility?

 

Your doctor may offer one of these treatment modalities depending on your requirements, age, and extent of disease.


Freezing your eggs: some doctors may recommend freezing of your eggs in case you wish to become pregnant later as endometriosis decreases ovarian reserve. 

Superovulation and IUI – may be an option for women with mild endometriosis, with patent tubes, and partner has good quality sperms. 

Fertility medications such as Letrozole and Clomiphene may be prescribed 

Regular ultrasounds to ensure egg maturity and timing of IUI

Advanced options such IVF, ICSI for moderate to severe endometriosis or women who have not responded to other treatments.

 

 

How can I improve my chances of getting pregnant with endometriosis?

 

It is important to live a healthy lifestyle which includes anti-inflammatory diet and pelvic exercises which helps by reducing inflammation in your body. 


Maintain a healthy weight 

Eating a well-balanced diet 

Moderate exercise 

 

Fertility treatment success is age dependent. Higher fertility is seen in younger population and women aged above 35 years are at greater risk of infertility as well as miscarriage.

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