Published March 2, 2019
Dr. Abayomi Ajayi
Being diagnosed with endometriosis – and the fertility problems that come with it often bring emotions of shock , denial , anger , and depression , particularly if you ’re planning to start a family. If you have been diagnosed with this disorder , you may have challenges starting a family or it could be that you have had one or more children previously and unable to have more children when you want to . Do not be surprised that endometriosis usually results in secondary infertility , and could readily cause emotional and / or physical distress.
From the wish to have a baby to the diagnosis of reproductive problems, the experience of infertility on its own can cause anger, confusion , depression, a sense of helplessness , and frustration . Having to cope with endometriosis on top of all this is challenging .
Imagine this scenario : You have experienced painful periods and discomfort for years before being diagnosed with endometriosis . Worse still , you ’re having trouble conceiving . Put together , it’ s a combination of emotions that require attention .
It ’ s normal to feel anxious, sad , and stressed , especially with the pain that comes first even before the infertility issues . Pain is physical and emotional with endometriosis . So you may have been dealing with such difficult issues for a while .
You need to be aware that not all women with endometriosis are infertile . Many women have children without difficulty , have children before they are diagnosed , or eventually have a successful pregnancy.
You may be overwhelmed because you don’ t feel ready to have children , or you want to have a child but you do not have a partner or have not been in the relationship for long or you are with a partner who is not ready to have children .
On the other hand , you may be among women ready to have children but can ’t get pregnant and as a result have feelings of frustration , hopelessness and are more prone to depression .
More often than not , it is during investigations to see why you are not getting pregnant that the diagnosis of endometriosis is made . In 30 per cent of women having difficulty becoming pregnant, endometriosis is the cause . So any problems experienced while trying to get pregnant may only be increased by the stress and shock of the diagnosis of endometriosis .
Endometriosis is a serious and uncomfortable condition, but the good news is that help is available and you ’re not alone .
About one in 10 women between ages 15 and 44 have trouble getting or staying pregnant even as endometriosis affects about 176 million women worldwide — or about one in 10 women , and as many as half of these women are struggling to get or stay pregnant.
About one- third of women with endometriosis have trouble with fertility and struggle to get pregnant. While they are likely to be affected in different ways , once pregnant, women may worry about the effect of their endometriosis on their pregnancy and delivery.
Reasons for infertility in pregnancy include issues related to scarring of the tubes and ovaries from endometriosis ; problems with the quality of the egg; problems with the embryo travelling down the tube and implanting in the wall of the uterus due to damage from endometriosis ; change of the organs in the pelvis, such as adhesions with scarred pelvic tissue and blockage of the fallopian tubes .
When you ’ re in a lot of pain , and your life is upside down , it can help to learn about the disease.
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Getting pregnant with endometriosis is possible , though it may not come as easily as expected . It has been established that up to half of the women with endometriosis will have trouble getting pregnant; however , the likelihood of having fertility problems depends on your age , your partner’ s fertility, and how severe the endometriosis is . If you ’re struggling to conceive , surgery or fertility treatments like IVF help . Perhaps you’ve been trying to conceive unsuccessfully for some time, and now, after a fertility evaluation and diagnostic laparoscopic surgery , your doctor has diagnosed you with endometriosis .
Or maybe you haven’t even started thinking about having children yet. However, after experiencing pelvic pain or severe menstrual cramps , investigation and diagnosis show you have endometriosis .
It is natural to wonder if you have any chance of conceiving . If you have been diagnosed with endometriosis before you even thought about getting pregnant, you may wonder if it’s worth trying to get pregnant on your own before seeking fertility treatment . The answer is yes . You can conceive with endometriosis . It ’s not a guarantee, but it is possible .
Your main concern after being diagnosed with endometriosis would be the impact it will have on current or future pregnancy plans . Rule of thumb is that women with infertility — who may not have an official diagnosis of endometriosis yet— are also more likely to have endometriosis . Some research has found that infertile women are six to eight times more likely to have endometriosis than those who don’ t struggle to conceive .
Also , of the one in four couples diagnosed of unexplained infertility , many may actually be dealing with mild endometriosis . An interesting aspect is that you could be having endometriosis yet be entirely without symptoms.
However, because endometriosis can only be diagnosed with invasive diagnostic laparoscopic surgery , your infertility could have been diagnosed as “unexplained ” .
You should always talk to your doctor about your specific situation.
But endometriosis doesn’t automatically mean you will experience infertility . If you have endometriosis , you will usually be advised to try conceiving naturally for six months (rather than the 12 months recommended for other women ). If you don’ t conceive within this time frame, you should speak with a fertility specialist. You may decide to go straight to a fertility specialist. If you ’re 35 years or older , you may not want to take the time to try to conceive on your own .
Pain can interfere with fertility simply by the fact that sexual intercourse may be too painful to perform . The pain itself does not interfere with your ability to ovulate or achieve fertilisation ; rather , it makes the act of sex difficult and sometimes unbearable . The amount of pain you experience isn ’ t necessarily related to the severity of the endometriosis . While severe endometriosis is associated with increased pain , it’s also possible for mild endometriosis to cause severe pain . It depends on where the endometrial deposits are located .
More pain doesn’t mean that it will be harder for you to get pregnant , it only impacts fertility in that you may be less able to have sexual intercourse .
In cases of moderate to severe endometriosis , surgery may be required to remove endometrial lesions or cysts and can reduce pain , but repeated operations can cause the build – up of scar tissues ( adhesions ) that increase the risk of infertility .
In very severe cases of endometriosis , the uterus , ovaries, or part of the ovaries may be removed. Of course this will impact your future fertility. Yet surgical removal of reproductive organs isn ’ t a cure for endometriosis as you may still experience pain .
One of the ways to cope with the challenge of endometriosis and infertility is to develop an action plan. Knowing that you are taking positive steps forward will probably also make you feel more in control .
Don ’t be afraid to ask for support and joining an endometriosis support group helps to voice your fears and frustrations . Endometriosis and general infertility support groups are available locally and I can help in linking you up with such groups.
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