Women with endometriosis have a lot of questions. Among the most common: Will I be able to get pregnant?
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Endometriosis can make it harder to conceive. But having this common condition doesn’t mean you should rule out pregnancy. Reproductive endocrinologist, Marjan Attaran, MD, explains how endometriosis affects fertility — and how women with the disease can take control of their diagnosis.
Endometriosis and infertility: What’s the link?
The endometrium is the tissue that normally lines the uterus. Endometriosis occurs when endometrial-like tissue grows where it shouldn’t, like on the fallopian tubes, ovaries or the pelvis. These endometrial-like implants cause inflammation and eventual scarring in the pelvis.
Doctors believe the inflammation makes it harder for the sperm and egg to rendezvous or for an embryo to implant in the uterus, Dr. Attaran says. In later stages of the disease, scarring can cause structural changes — like kinks in the fallopian tubes — that prevent the sperm and egg from hooking up.
Those complications can make it harder to get pregnant. Overall, 30 to 50% of women with endometriosis experience infertility. But Dr. Attaran adds, “There are a lot of gray areas when it comes to endometriosis.”
Getting pregnant with endo
What should you do if you have endometriosis and you’re ready for a baby?
- Talk to your doctor: Your plan of action depends on a lot of factors, including how old you are, how long you’ve been trying to get pregnant and how advanced the endometriosis is, says Dr. Attaran. “Get a doctor’s opinion based on your particular situation.”
- Surgery: Removing endometrial lesions can help manage pain from the disease — and it might boost your chances of getting pregnant. But repeated surgeries can cause scar tissue to form on the reproductive organs, which could be problematic. Your Ob/Gyn can help you weigh the pros and cons of surgery.
- In-vitro fertilization: IVF may not be cheap or easy, but it is effective. Women with and without endometriosis have similar IVF success rates, as long as their ovaries are still capable of producing eggs, Dr. Attaran says. “Since the egg and sperm are meeting in a petri dish, they have been removed from the inflammatory pelvic environment.”
Pregnancy and endometriosis
You might be wondering if it’s safe to even try to get pregnant. Some research suggests that women with endometriosis might have an increased risk of complications during pregnancy.
But Dr. Attaran says the research isn’t definitive — and her experience is encouraging. “My patients with endometriosis don’t seem to have significantly higher rate of difficulties with their pregnancies. Most of them do very well,” she says.
If you have endometriosis, the idea of growing your family might feel overwhelming. It helps to remember that endometriosis is common. As many as 10% of women are thought to have it — and a whole lot of them have gotten pregnant and delivered healthy babies. An endometriosis diagnosis isn’t something anybody wants. But knowing what you’re dealing with gives you some control, Dr. Attaran adds. “Instead of being scared of the unknown, you have the knowledge you need to consider your choices and take action.”