Endometriosis, Fertility and Pregnancy
Endometriosis is a common problem that happens in 1 in 10 women and can affect fertility. It happens when uterine tissues grows outside the uterus, causing scar tissue (adhesions). When endometriosis is minimal to mild, you are likely to be able to conceive naturally. However, when endometriosis worsens in severity, scar tissue also worsens and chances of conception reduce.
Severity of endometriosis
According to the American Fertility Society Revised Classification of Endometriosis (AFS) score, endometriosis is classified as:
- minimal
- mild
- moderate
- severe
The more severe, the less likely the woman is to get pregnant naturally. This does not always correlate with pain experienced by women. It is possible to have severe pain with minor endometriosis and minor pain with severe endometriosis.
Diagnosing Endometriosis
Laparoscopy is the most accurate approach to get detailed information about diagnosis and severity of endometriosis. Doctors look at the area affected, if there are cysts of endometriosis in the ovaries and whether there are adhesions sticking tissues together.
Endometriosis and natural conception
If endometriosis is minimal to mild, chances of conception are similar to normal circumstances. However, when adhesions become more severe, the chance of natural conception is reduced. This is because there are more adhesions that trap the egg and prevent it from getting down the fallopian tube.
Treating Endometriosis
At present, there is no treatment to treat or slow the progression of endometriosis. But symptoms can be managed. Pain can be managed with painkillers. Your doctor may also suggest surgery to remove adhesions which can reduce pain, as well as increase your chances of conception.
Endometriosis and Fertility Treatment
The type of fertility treatment depends on the severity of endometriosis, the woman’s age, how long the couple have been trying to conceive, whether the couple have conceived in the past and whether there are other fertility factors such as blocked tubes or sperm problems.
Treatments may include:
- Ovulation Stimulation
- Intrauterine Insemination
- Gamete Intrafallopian tube Transfer
- In Vitro Fertilisation
- Intra-cytoplasmic sperm injection
- Egg or sperm donation
- Surrogacy
If you have endometriosis and are trying to conceive, schedule an appointment with our specialist consultant to discuss your options.
