Endometriosis and Trying to Conceive
Endometriosis
Endometriosis is a painful, chronic disease that affects 5 1/2 million women and girls in the USA and Canada, and millions more worldwide. The word endometriosis means a problem with the endometrium or the lining of the uterus. Endometrial tissue is usually only inside your uterus. However, if you have endometriosis, tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas like the abdomen, on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and rectum; the outer surface of the uterus; and the lining of the pelvic cavity. Other sites for these endometrial growths may include the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars. Less commonly they are found in the lung, arm, thigh, and other locations.
Normally, every month when you have your period, the uterine endometrial lining comes out in your menstrual flow. If you suffer from endometriosis then all the misplaced tissue in your viscera responds to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.
Diagnosis of endometriosis is done by laparoscopy, a minor surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the endometrial growths.
Some of the symptoms of Endometriosis are:
- Pain before and during periods
- Pain during sex
- Infertility
- Fatigue
- Painful urination during periods
- Painful bowel movements during periods
- Other Gastrointestinal upsets such as diarrhea, constipation, nausea.
- Allergies
- Chemical sensitivities
- Frequent yeast infections
Endometriosis and Trying to Conceive
There is a lot of ambivalence over how endometriosis affects a woman's chances of getting pregnant. But studies have shown that a woman with endometriosis is less likely to conceive than a woman without. Statistics say that 20% of women who have endometriosis and are trying to conceive will not succeed. So, for every 100 women with endometriosis who are trying to conceive, 80 of them will not have problems getting pregnant.
It is also been shown in various other studies that women with endometriosis conceive at lower rates than women without endometriosis and miscarriages are more common in endometriosis patients than in those who do not have the disease. Help is available to these women in the form of surgery where the excess of the tissue is removed from other organs of the viscera. These treatments can be optimized with a combination of good excisional therapy and medical suppressive therapy if there is any suspected residual disease.
If you suffer from mild endometriosis you should continue to attempt pregnancy. Use of ovulation induction with clomiphene citrate (Clomid or Serophene) can also help. Also, a technique called washed intrauterine insemination has been shown to improve pregnancy rates in women with endometriosis if given sufficient time without other factors like irregular ovulation, male factors, or cervical factors.
With moderate to severe endometriosis, surgical excision of all the disease with reconstruction and restoration of anatomy has been shown to achieve pregnancy rates that are higher than for untreated women. Some studies have suggested that post-surgical medical suppression with gonadatropin agonists (Lupron, Synarel, Zoladex) will improve pregnancy rates in women with endometriosis. These therapies can also help to relieve pain in endometriosis patients.
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