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7 February 2023
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How Endometriosis Affects Pregnancy

Medical research shows that about one in every three women has trouble getting pregnant, and at least one in every nine women has endometriosis. In many cases, a pregnant woman with this condition can have a successful and uncomplicated pregnancy. In addition, some women with endometriosis may not be aware of it. Contrarily, to others it comes with symptoms such as pain. Keep reading to learn more about endometriosis.

What is Endometriosis?

Endometriosis is a condition where tissue similar to the one lining your uterine walls grows outside the uterus. It most frequently affects the tissue lining your pelvis, fallopian tubes, and ovaries. It is rare to find endometrial-like tissues growing beyond pelvic organs. With this disorder, the endometrial-like tissue behaves like a wound; it thickens as it grows.

During the menstrual cycle, these tissues break but they do not flow out with menstrual blood since they cannot exit your body. When endometriosis attacks the ovaries, it forms cysts called endometriomas. These cysts may irritate the surrounding tissues hence forming scar tissues. It can also form thin fibrous adhesions, leading to pelvic tissues and other organs sticking together.

Endometriosis can result in excruciating pain, especially during the menstrual period. It can also lead to infertility problems, but the good thing is that it is curable.

Categories of Endometriosis 

There are three main categories of endometriosis, depending on the area it attacks: 

Superficial peritoneal lesion

It is the most common and appears in the pelvic cavity. It appears as lesions in the peritoneum, the thin pelvic lining. 

Endometrioma

It’s also called an ovarian lesion. It forms dark cysts with fluid inside, commonly known as chocolate cysts. They can cause significant damage to healthy tissues because they rarely respond well to treatment. 

Deeply infiltrating endometriosis

It develops beneath your peritoneum and may affect the bowels, bladder, or other organs close to your uterus. It affects about 1% of every 5% of women with endometriosis.  

Common Symptoms of Endometriosis 

The primary and most noticeable symptom of endometriosis is pelvic pain, especially during menstruation. Although many women suffer cramps throughout their periods, individuals who have endometriosis frequently have notably more severe menstrual pain than usual. Over time, pain may potentially get worse. 

The following are the common symptoms of endometriosis:

Dysmenorrhea or painful menstrual periods

You may experience cramps or pelvic pain before your menstruation period and some days after. In addition, sometimes, the pain can extend to your abdomen or lower back. 

Pain during urination and bowel movement

You experience intense pain when urinating or during bowel movements. These symptoms are most common during your menstruation time. 

Excessive bleeding

Endometriosis can cause heavy menstruation or bleeding during menstruation, intermenstrual bleeding. 

Infertility

Most doctors first check for endometriosis when addressing infertility problems. 

Besides the above, you may also experience other signs, like diarrhea, fatigue, constipation, nausea, or bloating, during your menstrual periods. 

While some of these symptoms might seem normal with menstruation, it is advisable to see a doctor when you suspect they might indicate endometriosis. Furthermore, the condition might be challenging to manage. However, an early diagnosis and a multidisciplinary team of doctors who understand your diagnosis can help manage the symptoms. 

Can Endometriosis Affect Fertility? 

The misconception regarding endometriosis and infertility makes most women fear that they will never get pregnant after testing positive for the condition. 

Below are reasons why you should not panic about having babies, even when you have endometriosis. 

Endometriosis Does Not Render You Infertile 

Endometriosis occurs when uterine lining cells grow in places they should not, such as the fallopian tube and ovaries. These growths can cause the formation of scars or blocking of the fallopian tube, which may make it hard to conceive. Yet, this intensity varies with women, with some having a few spots while others suffer extensive endometriosis. Nonetheless, according to medical experts, while endometriosis can make it hard for patients to get pregnant, it does not always have to be the case. There are still high chances of conceiving even with this condition. 

It Is Okay to Try Conceiving Even with Endometriosis 

Getting diagnosed with endometriosis does not necessarily mean you have to consult a doctor when you want to get pregnant. Even so, if you try for about six to seven months without success, it is advisable to consult a fertility doctor. Your doctor will check to confirm if endometriosis could be the contributing factor to your infertility. 

There are Various Endometriosis Treatments 

If you have fertility problems as an endometriosis patient, the first thing is to seek medical attention. Your doctor should check the fallopian tubes’ condition to ascertain whether they are open. Endometriosis can significantly impact women’s fertility in two major ways: microscopic and macroscopic issues. 

Most patients with macroscopic disease develop scar tissue and lesions that block the fallopian tube and hinder the ovum from reaching the uterus. Conversely, some women with endometriosis have open tubes but still struggle with fertility, a condition called microscopic endometriosis. Therefore, you need to consult your doctor to determine the extent of your disease and its impact on fertility. 

Depending on the extent of the condition, the doctor may prescribe oral medication or more advanced treatments like surgery. There are several treatment methods that your doctor can recommend. The following factors influence the treatment method that suits you best:

  • Age 
  • Reproductive history
  • Your fertility evaluation results
  • Overall health 

How Common is Endometriosis?

Endometriosis is a common disorder affecting about 10% of women of reproductive age; between 15 and 44 years globally. Although, the conditions may be hard to detect in many patients due to its broad and viable symptoms. Additionally, most women with early-stage endometriosis lack awareness and mistake the symptoms for normal menstrual discomfort. As a result, the condition may worsen due to the extended period between the start of symptoms and the condition’s diagnosis. Consequently, more research and awareness about the disorder’s timely diagnosis, symptoms, prevention, and management are necessary. 

What are the Chances of Getting Pregnant with Endometriosis?

Women with endometriosis disorder can still get pregnant, but it might take longer than usual. Research shows that approximately 40% of women struggling with infertility problems have endometriosis. Since some women can conceive easily while others struggle, it is advisable for you and your partner first to try conceiving naturally. 

If you are under 35 years of age and fail to get pregnant after trying for a year, it is time to seek medical attention. Similarly, women above 35 years should consider seeking medical help after trying for six months in vain. Normally, Your doctor performs a medical evaluation to assess the impact of endometriosis on your fertility. Nonetheless, since the condition comes in stages, medical experts suggest that about 70% of women with mild endometriosis have higher chances of conceiving naturally. 

How to Get Pregnant with Endometriosis Naturally 

As difficult as it seems, you can still get pregnant naturally with endometriosis. Up to 70% of endometriosis patients can enjoy a natural pregnancy within three years. There are various ways to increase your chances to get pregnant with endometriosis. Below are some ways to better your chances of getting pregnant with endometriosis:

Track and understand your menstrual cycle

If you understand your cycle well, you can take advantage of your fertile window since you know when you are ovulating. You may opt for digital fertility monitors to track your menstrual cycle naturally. However, even with this understanding, it would help to try intercourse positions that minimize the endometriosis pain for a successful conception. 

Check your diet

The foods you eat significantly impact the severity of your endometriosis symptoms and fertility. Thus, it is best to eat foods that reduce the inflammation in your body and make it more homely to accommodate a baby during pregnancy.

Check out some foods to include in your diet:

Omega 3 fats-rich Foods 

According to research, consuming foods rich in omega-3 fats, such as nuts, oily fish, and seeds, can help reduce inflammation remarkably. They also help prevent lesions that come with endometriosis. Your body requires more omega-3 than omega-6 foods. Foods like eggs, sunflower seeds, poultry, and meat contain a high percentage of omega-6. 

Antioxidants-rich Foods

Medical experts recommend antioxidant-rich foods and supplements to reduce the chronic pain of endometriosis. Further research indicates that antioxidants reduce chronic pelvic pain, oxidative stress, and inflammation within a few months of consumption. They play a significant role in boosting fertility in endometriosis women. 

Below are some rich sources of antioxidants:

  • Berries, incredibly dark berries 
  • Dark leafy greens
  • Dark chocolate 
  • Spinach
  • Beetroots 

Anti-Inflammatory Foods

Mediterranean or anti-inflammatory dietary habits have a provable impact on the severity and symptoms of endometriosis. As a result, it helps boost fertility naturally. 

Cruciferous Vegetables

Brassica vegetables are a rich source of fiber and help lower the estrogen levels in your body, which is essential for women battling endometriosis. What’s more, if you are trying to conceive, cruciferous vegetables can boost your fertility by balancing sex hormones and reducing inflammation in your body. Here are some of the vegetables in this category: 

  • Turnips
  • Cauliflower
  • Broccoli
  • Bok Choy
  • kales
  • Cabbage 
  • Brussels 

Maintain a Healthy Weight by Exercising 

Healthy weight and regular exercise have a way of improving endometriosis symptoms and boosting fertility. Moderate activities such as swimming, aerobics, lifting weights, and walking can reduce inflammation that comes with endometriosis. Research suggests that women who exercise regularly have less oxidative stress and inflammation in their bodies compared to those who do not. Hence, it would help to include some minutes of exercise in your daily schedule if you want to conceive naturally with this condition. 

Avoid Harmful Foods 

The key to conceiving naturally with endometriosis is reducing the levels of inflammation in your body. While there are essential foods that you need to add to your diet, there are also those that you must avoid. 

  • Processed foods and sugars – these foods crucially raise inflammation in your body. So, minimizing their intake can help better your chances of getting pregnant. 
  • Trans Fats – Trans foods, common in fried and fast foods, have higher chances of increasing the risk and severity of endometriosis. 

So, an active lifestyle and healthy eating are vital requirements if you wish to get pregnant naturally even with endometriosis. Since endometriosis is closely connected to infertility, these are simple do-it-yourself ways to increase fertility chances. 

Can You Get Endometriosis After Having a Baby Naturally?

Like other postpartum infections, you can get endometriosis after giving birth. While any woman can get this condition, the risk is about five to ten times higher in women who deliver through C-section than in vaginal deliveries. 

Besides cesarean section delivery, more factors can contribute to postpartum endometriosis. Below are some of them: 

  • Prolonged labor
  • Postpartum hemorrhage
  • Bacterial vaginosis
  • Infections during pregnancy
  • Delayed rupture of the fetal membranes 
  • Newborn waste inside the amniotic fluid 
  • Incomplete removal of placenta or removal by hand 
  • Internal examinations during child labor 

The good thing is that with a timely diagnosis, postpartum endometritis is treatable.

Diagnosis and Treatment of After-Birth Endometriosis 

Any infections that occur within the first 24 hours after delivery are easy to detect because you are still under medical care. After that, it would be best to check with your doctor if you suspect any infections. The doctor will diagnose by asking about the symptoms and carrying out tests. The tests can be via urine, blood, or vaginal swabs. 

If the test results indicate endometriosis, treatments should commence immediately. There are various kinds of antibiotics for treating postpartum endometriosis. The administration is usually with an IV, but physicians occasionally administer these antibiotics using injections. 

Gentamicin, ampicillin, and clindamycin are the three most effective postpartum endometritis antibiotics. Depending on the condition’s intensity, the doctor may recommend one or a combination of all three. If your doctor discovers postpartum endometriosis and treats it promptly, it does not leave any lasting effects. However, if left untreated for a long time, the condition can advance to sepsis, a life-threatening infection that spreads throughout your bloodstream. 

Best Age to Get Pregnant with Endometriosis

It is easier to get pregnant in your twenties than in your thirties and older if you have endometriosis. Therefore, it would be best to discuss your options with your doctor if you have the condition and plan to get pregnant. Still, about 70% of women with mild endometriosis can conceive at any reproductive age. 

Can You Still Get Pregnant After Stage 4 Endometriosis?

Women with stage 4 or severe endometriosis may find it extremely difficult to get pregnant. The condition in this stage causes fallopian tubes to block, resulting in extensive scarring, and sometimes damages ovaries. The stages of endometriosis have an impact on the level of infertility. Consequently, it is critical to understand your condition’s stage by consulting your doctor.

Endometriosis Stages and Infertility Risks

During the diagnosis, your doctor will brief you about  the stage you are in, thereafter describe its severity. The stages vary depending on the condition’s location, the extent of tissue overgrowth, and the amount. Generally, early stages 1 and 2 have higher chances of conceiving than 3 and 4. 

Here is a breakdown of the endometriosis stages:

Stage 1

It is the minimal stage of endometriosis and rates five points at maximum. Here, the implants are superficial, tiny, and few. The implants occur in tissues or organs that line the abdominal cavity and the pelvis. It includes minimal or no scar tissues. 

Stage 2

Stage two is commonly referred to as the mild stage and rates between six and fifteen points. The implants in this stage are more and more profound than those in stage one. Some scar tissues may occur, but it is not a significant sign of active inflammation. 

Stage 3

Stage three is the moderate disease stage and rates about sixteen to forty points. It is characterized by many deep endometrial cysts and endometrial implants dominating the ovaries or at least one of the ovaries. When the endometrial tissue attaches itself to the ovaries, it forms ovarian endometriomas. The tissue then sheds, collecting old, dark brown blood along with it. Ovarian endometriomas are sometimes called chocolate cysts due to the appearance of the blood. 

Stage 4

It is the most severe stage of endometriosis, with over 40 points. It includes severe adhesions and a large volume of cysts. Typically, you would expect cysts to disappear on their own, but endometriosis cysts require surgery to remove them. Sometimes endometriosis can grow as large as a grapefruit. 

In this stage, cysts, lesions, or scar tissues may overgrow to block one or both of your fallopian tubes, causing infertility. While you have some chance of getting pregnant naturally in this stage, endometriosis treatment may be necessary to increase your chances. 

Can You Get Pregnant with Endometriosis and PCOS?

If you have endometriosis or polycystic ovary syndrome (PCOS), you might worry about being unable to conceive. However, women with these two conditions might need to put in some effort since it may be difficult. These conditions, especially endometriosis, hinder conception by forming endometrial overgrowths that block the fallopian tubes. They can also reduce your chances of getting pregnant by interfering with your ovulation. 

On the other hand, PCOS affects fertility through hormonal imbalance. It becomes difficult to get pregnant when an excess circulating hormone, androgen, hinders ovulation. The high-insulin resistance and the insulin-like growth factor accelerate androgen production in women with PCOS. The result is excessive weight gain that leads to type two diabetes. 

Experts describe this condition as metabolic inflexibility. If you have this condition, weight loss, a critical step in trying to conceive, becomes a harrowing journey. Medical experts suggest that losing at least 20% of the current weight can increase the chances of getting pregnant in women with PCOS. 

How to Boost Chances of Getting Pregnant with PCOS 

The best way to manage your PCOS symptoms and boost your chances of getting pregnant is by leading a healthy lifestyle. Adjusting and improving your eating habits and increasing your exercise level is crucial in boosting fertility. Some nutritional experts recommend adopting a healthy diet, emphasizing the Mediterranean diet. Furthermore, you can seek help from your doctor to create a customized diet plan to accelerate your weight loss, improve your overall health, and better your chances of conceiving. 

Autoimmune diseases may make it more difficult for women with PCOS or endometriosis to get pregnant. For instance, women with PCOS or endometriosis may find it more challenging to get pregnant in the event they suffer from a thyroid disorder. Hypothyroidism makes it challenging to lose excess weight. Additionally, subclinical hypothyroidism makes the efforts less fruitful as it interferes with ovulation. Thus, if you have PCOS and you are finding it hard to conceive, it is advisable to have your doctor check your thyroid hormone level. 

Comparably, autoimmune disorders such as systemic lupus make your chances of getting pregnant slimmer if you have endometriosis. Immunosuppressant agents and steroids that treat systemic lupus often reduce the body’s fighting power on endometrial tissue overgrowth. This worsens endometriosis symptoms. That being so, if you have other conditions besides endometriosis and PCOS, it would be best to work with your doctors to achieve your health goals and boost your chances of having babies. Depending on your condition, the doctor will sometimes administer a lupron shot for endometriosis. 

Endometriosis and Pregnancy

If you have endometriosis, it is common to worry about having children, but the good news is that it is not as bad as it looks. You can conceive and carry the pregnancy to term and have healthy babies. Here are some amazing facts you need to learn about endometriosis and pregnancy. 

You may take longer to get pregnant with endometriosis 

There are various reasons behind delayed pregnancy in women with endometriosis. First, scar tissues or pelvic adhesion may hinder the ovum from moving down the fallopian tube. Also, endometrial inflammations in the pelvis may lead to the production of cells that shorten the lifespan of sperm. If endometriosis attacks the ovaries, it can lead to the production of low-quality eggs. While these factors can make it harder to conceive, a proper diet and lifestyle can help improve your chances.

Infertility issues are common with severe endometriosis 

Women with stage 4, severe endometriosis, have a more difficult time trying to get pregnant. Due to the high risk of infertility at this stage, some women may require some reproductive technology to get pregnant. Further, endometriosis treatments like surgery to remove overgrowths outside the uterus can help improve your chances. 

Though, the stage of the disease determines the success of the treatment and the chances of conceiving. 

Endometriosis can slightly increase the risk of miscarriage 

Some gynecological studies show that women with endometriosis have a higher risk of miscarriage. Other obstetric and gynecological researches indicate that endometriosis patients who undergo intracytoplasmic sperm injection (ICSI) or In Vitro Fertilization (IVF) have double the risk of miscarriage. 

But, even with that, many women who have endometriosis carry pregnancies to term and deliver healthy babies. Still, it would help to seek help from a good obstetrician-gynecologist throughout your pregnancy. 

Endometriosis can increase the risk of ectopic pregnancy 

Medical studies indicate that women with endometriosis have a higher risk of ectopic pregnancy than those without the condition. An ectopic pregnancy occurs outside the uterus, mainly in the fallopian tube. The increased risk results from damaged fallopian tubes due to endometrial overgrowths. 

Endometriosis symptoms can improve with pregnancy 

Hormone changes during pregnancy improve the endometriosis symptoms and make the condition more bearable. With the absence of menstrual cycles and the presence of the dominant progesterone, most women do not experience the severe symptoms of endometriosis. The situation is better without the excruciating pain. 

During this period, some lesions disappear or regress, but some remain stable, and some patients can still experience the growth of these lesions. Generally, pregnancy experience varies from one endometriosis patient to another. For instance, if you experience pain from endometriosis during pregnancy; You can take medications for endometriosis, like acetaminophen. Yoga, massage, acupuncture, or breathing exercises could also be handy. 

Breastfeeding can temporarily reduce the endometriosis symptoms 

The impact of breastfeeding on endometriosis also results from hormonal changes. It works by inhibiting the release of estrogen, frustrating ovulation, and endometrial lesion growth. Consequently, breastfeeding women with endometriosis experience less pain and discomfort. 

Nevertheless, this relief may not last long as the symptoms may resume once you resume your menstrual cycle. 

Pregnancy does not cure endometriosis 

Even though pregnancy and breastfeeding periods may suppress the symptoms of endometriosis, they tend to return once you stop breastfeeding and start your menstrual cycle. The rate at which the symptoms resume is higher in women who deliver through C-section than vaginal birth. Nonetheless, since the return of the symptoms varies from one woman to another, it is advisable to wait for some time before resuming your preventive medications for endometriosis. 

Early Pregnancy with Endometriosis

Endometriosis can be problematic in the early stage of pregnancy and poses risks to both the mother and the baby. Medical experts agree that the risks only manifest in a smaller percentage since most women with endometriosis carry their pregnancies to delivery without complications. 

Below are some endometriosis-related risks in early pregnancies: 

Miscarriages 

Various studies argue that miscarriage rates are higher in women with endometriosis than in those without the disease. While it might be impossible to stop a miscarriage, recognizing the symptoms can help prevent it from happening. The following are the most notable signs of a miscarriage.

  • Cramping
  • Bleeding
  • Passage of tissues 
  • Lower back pain

Once you notice any of these symptoms, it would help to seek medical attention immediately. 

Preterm Birth 

Women with endometriosis are more likely to deliver preterm, before 37 weeks than pregnant women without the disorder. Preterm babies often have low birth weight and are more likely to have health, growth, and developmental challenges. Signs like regular contractions, pressure in your pelvis, and change in your vaginal discharge may indicate the possibility of preterm birth. 

Placenta Previa

Placenta previa occurs when the placenta sets itself near or directly to the cervix opening. If this happens, you have a high chance of bleeding and placenta abruption, a dangerous condition where the placenta detaches from the uterus prematurely. 

The first sign of placenta previa is red vagina bleeding. Suppose the bleeding is minimal; doctors recommend limiting your exercises, including sex. However, if it is intense, it might necessitate blood transfusion and immediate C-section. 

Can Endometriosis Affect Pregnancy Results? 

If you have endometriosis, you can get false negative pregnancy test results on the first attempt. Therefore, it would help to take the test more than once with your primary healthcare provider to be sure. 

How to Find Endometriosis Specialist

Finding a qualified endometriosis specialist is the biggest dilemma for most women with endometriosis and those suspecting they have the condition. Finding all the services you need in one individual could be tricky. It would be best if you had a specialist who understands endometriosis and its various treatment methods and is open to different approaches. The specialist also needs to be compassionate and possess the necessary surgical skills. 

You can search for a specialist online by searching “endometriosis specialist near me” or ask for referrals. Once you have a  potential specialist, do a background check on how they have previously handled patients who had endometriosis. You can rate their expertise and knowledge by asking basic questions, for example; the disease’s appearance, stage, and possible treatment options. After your first appointment with the doctor, you can decide whether to trust the specialist or choose otherwise. 

The Bottom Line 

The thought of endometriosis can be peace-threatening, but the reality is not as bad. Majority of women fear that they may become infertile after being diagnosed with endometriosis. But the good news is that, you can still get pregnant even with the condition. It is, however, recommended to seek medical attention immediately if you experience signs of this condition. Early diagnosis is crucial in managing endometriosis.