Infertility

Endometriosis does not only make women's lives miserable through pain, but often has the potential to deprive them of the experience of motherhood. The disease can often lead to total infertility. Unfortunately, the statistics are alarming: at least 20 out of 100 patients who want to have children fail to conceive, and spontaneous abortions are more common. In infertile women, endometriosis is found to be the cause of infertility in 35-40°% of the cases examined.

How can endometriosis lead to infertility?

The exact causes of endometriosis-related infertility (infertility) are still not fully understood. A group of researchers published a summary study in 2006, which used the MEDLINE database to review research on the subject between 1960 and 2003. Infertility can be caused even in the mildest form of the disease, when there is no pain or other symptoms. In many cases, the diagnosis itself is made at the time of the infertility investigation.

Unfortunately, endometriosis can have a number of causes of infertility. Symptoms include very painful intercourse and the bleeding that comes with it. Often the pain can be so severe that the woman may withdraw from physical contact altogether. This means that sexual intercourse is reduced and the subsequent bleeding can make it more difficult to conceive. But that's only one side of the coin: women who want to have children often overcome these problems.

However, there are also other complicating factors. In the course of my research, I came across a number of lessons that abnormal immune system behaviour in women with endometriosis. Sperm and fertilised eggs are foreign to the body and as such trigger a defensive reaction. In normal function, other processes override these to protect the zygote, but in endometriosis the immune system attacks it, reducing the chances of successful implantation and delivery. And the fluid produced by the peritoneum contains a much higher number of immune cells than in healthy women, so the attack on the foreign material is much more rapid and intense.

In addition, the patient may also have abnormally located endometrial nodules in a place or causing scarring, adhesions that make it impossible to conceive spontaneously,  for example, even can also block the fallopian tubes. Scarring on the surface of the ovaries makes it difficult for the egg to exit during ovulation, and the inner surface of the ovary can also become scarred, preventing the sperm and fertilised egg from reaching the right place, and if pregnancy does occur, it is more likely to stick outside the womb, putting the mother's life at risk.

I'm going to have a baby. How can I increase my chances of getting pregnant with endometriosis?

There are several options if you want to have a biological child despite the difficulties. Pain relief is usually the first and most important factor. Of course, this won't get you pregnant, but at least you'll have the energy and desire to do something about it.

You can be given hormonal treatment to stop endometriosis nodules from growing, but these can make you temporarily unable to conceive. After laparoscopy, there is a longer period of up to six months to a year when your chances of getting pregnant increase, so if you have had this operation, it is worth taking advantage of it. In the treatment of endometriosis, hormone treatment is usually given after the laparoscopy to prevent the tiny lumps that are not yet visible to the eye from growing as a result of the cycle, and the baby project can then begin. The treatment usually lasts three to six months.

Medicines commonly used for infertility can help in cases where scarring makes it difficult for a mature egg to be released. Oral medication or injectable treatment can help ovulation to occur, and thus pregnancy. The success of the method can be enhanced by the simultaneous use of insemination, when the sperm is injected directly into the uterine cavity, thus avoiding the "problematic" areas.

There are doctors who claim that medication after laparoscopy can increase the chances of getting pregnant, especially in cases of minimal and mild cases of artificial insemination, but if the endometriosis is severe and extensive, they say it will not help. They stress that the key factor in treating endometriosis-related infertility is speed, not waiting until the disease becomes severe. It is important that as little time as possible elapses between diagnosis and the start of therapy.

Research summary shows that the best chance of getting pregnant is controlled in utero fertilisation with ovarian hyperstimulation is available for minimal to mild endometriosis after the disease has been surgically treated. If this does not help, there remains the psychologically, physically and financially demanding option of artificial insemination, insemination and then lombikprogram. 

Particularly in cases where there is an organic cause, i.e. a disease in the background, and not functional infertility, these procedures can help. The excessive activity of the immune system is usually reduced by steroids during the process in cases of endometriosis. If a pregnancy does occur, this is not a problem, as the endometriosis will largely regress in the 9 months that follow. However, if the fomb is unsuccessful, not only do you have to deal with feelings of failure and grief, but you also have to physically recover from a worse condition.

If IVF methods don't work, or you don't want to try them, you can use the adoption. it is important that you only do this once you have come to terms with your grief over the loss and wholeheartedly accept the path that will help you have a child. Those with a very combative nature, who do not shy away from financial outlay, often surrogacy programme abroad This procedure is not listed in the Health Act among the special procedures for human reproduction that can be performed in Hungary, so it cannot be officially performed in Hungary, in Hungarian hospitals, by Hungarian doctors. Surrogacy itself has always been a controversial option, for understandable reasons, and I have recently researched the issue in detail, you can read my summary article on the blog.

Not all women with endometriosis are infertile, and some have babies without any particular difficulty. According to a study by P. Härkki and colleagues, slightly more than half of women with endometriosis are able to conceive either naturally or through artificial insemination.

Hormonal changes during pregnancy can have a positive impact on the condition of endometriosis patients. It is important to stress, however, that this does not mean a complete and permanent cure, as endometriosis nodules can reappear after pregnancy, when menstruation returns, and with them the unpleasant symptoms. Many doctors, with absolute benevolence, but without thinking about the essential elements, prescribe childbearing as the most appropriate therapy, almost as a 'prescription' for the woman who is ill. Needless to say, this solution leaves much to be desired in many respects. A single woman can have endometriosis, a young woman can have endometriosis, and a woman who may not yet be able to take on the responsibility of having a child, either psychologically or financially.

Have a baby when you and your partner want to have a baby, when you planned to have a baby, when you wanted to have a baby, not when you are afraid of endometriosis, because "prescription" babies are not a real solution and they put too much strain on a relationship that is not ready to have a baby.

If you need help, HERE you can book a consultation with me!