Everything You Need To Know About Endometriosis And Infertility

By Karol Cardinson

Depending on which reference source one reads, women with endometriosis have a fertility rate of 50 to 65 percent, whereas the general population of women has a fertility rate of 88 percent. Among women with endometriosis, it is believed that 30 to 50 percent are infertile, although the true incidence of infertility is unknown, For that matter, no one knows the true incidence of infertility in the general population.

The paradox of infertility in endometriosis is that most of the standard medical treatments for the disease are contraceptive. Endometriosis is essentially an estrogen-dependent disease; the drugs used to treat it deplete the body of estrogen and therefore shrink the endometriomata. But pregnancy also is estrogen dependent. So it's unlikely that you will become pregnant while you are receiving treatment, and when you go off the drugs in an effort to have a baby, your endometriosis will probably get worse again.

To add to the irony, drugs that increase the chance of conception also tend to exacerbate endometriosis. They have other serious side effects as well, so if you feel as though you are between a rock and a hard place, you are.

What's more, if endometriosis does indeed cause infertility, then eradication of the disease should render a woman fertile. Unfortunately, it doesn't always work that way. Treatment of mild to moderate disease does not necessarily improve the rate of fertility over doing nothing. You may become pregnant after treatment but according to statistics, the general incidence does not increase. Women who undergo various treatments for endometriosis, and who also are being evaluated for fertility, have variable outcomes in the success of the treatment on fertility. This suggests that endometriosis affects individual women's ability to become pregnant in different ways.

If the disease is caused by an anatomical abnormality, surgery to correct it may or may not be effective-depending on the skill of your surgeon and whether you develop serious adhesions. If you have the predisposition to endometriosis since you were in your mother's uterus, chances are the longer you wait, the less likely you are to get pregnant.

If you decide to have surgery (the less invasive the procedure, the greater the chance of preserving whatever fertility you have), timing becomes even trickier. Most physicians believe that there is a postoperative "window of opportunity" that lasts about six to nine months. This is when you luck is at its peak. After about nine months of menstrual periods after surgery, if there are still some endometriomata left in your abdomen, the buildup of scar tissue, cysts, and adhesions will once again impair fertility.

One extremely frustrating thing about endometriosis and infertility is that the disease appears to increase the chance of natural abortion (miscarriage). So there are women who can become pregnant but cannot carry to term. Surgery and medication may help correct this problem, but so far no scientific data exists. - 30525

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