Being able to conceive and give birth to a new life is something that most women dream about. The natural instincts of motherhood give a lot of joy to women after they reach a certain age and this is something that is hormone driven so that they are inspired to get pregnant and give birth, keeping the life cycle of humans regular and growing.

A lot of women may be able to easily conceive and go through a natural pregnancy without any major glitches or problems, but everyone may not be as lucky and there may be those women who may be suffering from health issues that make it difficult for them to conceive.

One problem in women that may lead to difficult in conceiving or infertility may be the problem of endometriosis. This is a health issue that affects the uterus and it is defined as a problem in which the lining of the uterus grows outside of it, disturbing menstrual cycles as well as the ability to conceive and carry a foetus in the uterus.

Is it possible to get pregnant?
There is widespread misconception that women who suffer from endometriosis may never be able to conceive because the uterus lining that is needed for the inception of the embryo in early pregnancy may be missing. However, the truth is that the problem is a treatable one and with the right medical help and guidance, it may be possible to make sure that the problem is brought under control or reversed and that a successful pregnancy may be achieved.

While it is possible to reverse the problem, it is also important for aspiring couples to choose the right gynaecologist for the treatment, because it is a complex issue that can be resolved only with expert and experienced interference. The medical professionals may put you under medication that works on the hormones and creates ways to reverse endometriosis. However, in patients who suffer from severe endometriosis, a surgery may be one of the alternative treatments.

The relation with pregnancy:
As it is suggested by experts in the field of gynaecology, finding difficulty in conceiving may be a real possibility. However, with the help of modern medical practices such as in vitro fertility, it may be possible to conceive when all other forms of treatment fail and in order to achieve such a feat it may be important to trust a doctor that has a perfect backing of knowledge and experience in the field.
The modern world of medicine is no shorter than a marvellous miracle, however, the success or failure of any treatment depends a lot on the kind of medical aide and specialist that you decide to opt for.

Endometriosis - How it Affects Pregnancy?

The uterine cavity has a tissue base that is known as the endometrium. When this endometrium spills over or spreads to the other parts of the reproductive organ, it begins to punch through the uterine lining. Such a condition creates complications and even infertility, and is known as endometriosis.

Read on to know more about endometriosis and how it can cause infertility.

Endometriosis

When the endometrium tissue spreads to areas like the ovaries, and the abdominal cavity, it can lead to numerous complications. Apart from pain, this may also cause infertility. 5 to 10% of the women worldwide suffer from this condition and have trouble conceiving. Additionally, about 30 to 40% of the infertility cases are due to endometriosis, not all cases. These figures are all confirmed by various medical studies.

How does it cause infertility?

Endometriosis can prevent ovulation, which is the process that occurs every month. During the ovulation process, the ovaries release eggs that may be fertilised in order for the woman to conceive. In this condition, the fimbria of the fallopian tubes also has trouble in capturing the egg, which prevents conception from taking place. This leads to infertility in the long run. Endometriosis also interferes with the proper production of the hormones that are required for normal ovulation and fertilisation of the egg.

Diagnosis: The diagnosis of the condition can be done with the help of lab tests and ultrasounds as well as imaging tests that can create the image of the womb and the endometrium lining. This will help in showing the severity and damage caused by the tissue. A surgical procedure called a laparoscopy may be carried out by the doctor to ascertain whether the patient is suffering from this condition. In this procedure, a small incision will be made and a camera will be inserted to view the insides on a screen, to learn more about the tissue s spread and the kind of treatment that will be required. The doctor will also diagnose the condition on the basis of various symptoms like irregular and heavy bleeding.

Treatment:

Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the age of the woman, the severity of the disease and its location in the pelvis, the length of infertility, and the presence of pain or other symptoms. Some general issues regarding treatment are discussed below.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.

However, several well-controlled studies have shown that neither medical or surgical treatment for mild endometriosis improve the pregnancy rates for infertile women as compared to expectant management (no treatment).

For treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination - IUI is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present.

Details about IUI success rates with endometriosis

IUI and endometriosis

Success rates with IUI for endometriosis have been variable in studies, showing:

A pregnancy rate of 6.5% for women with endometriosis vs. 15.3% per cycle for unexplained infertility
A pregnancy rate of 5.6% for women with advanced endometriosis vs. 22.7% per cycle for mild endometriosis vs. 25.7% for no endometriosis
Pregnancy chances with insemination for natural cycle IUIs (no drugs) with endometriosis are about 2% per cycle vs. 11% with injectables plus IUI for endometriosis
Treatment for severe endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women.

Unfortunately, the infertility in women with severe endometriosis is usually resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, artificial insemination is unlikely to be successful. These women often require in vitro fertilization in order to conceive.

Although the studies of in vitro fertilization for women with severe endometriosis do not all show similar results, pregnancy success rates are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation.

Endometriosis - How It Results in Infertility?

One of the silent diseases in the female population, endometriosis can be symptomless for years and sometimes even decades, but can sometimes manifest itself quickly. The uterus is lined on the inner side by a tissue known as endometrium. When this tissue is found in other parts (fallopian tubes, abdomen, near the ovaries, etc., it is known as endometriosis.

Causes: The exact cause for endometriosis is not clear. There is a possibility that during the regular period, there could be spilling of the tissue back into the fallopian tube, from where it reaches the ovaries or other organs and gets implanted.

There are certain predisposing factors for a woman to develop this condition, including genetic correlation and non-menopausal women. The female hormone estrogen is essential for the development of endometriosis. There are also immunological reasons attributed to the development. It can range from minimal to mild to moderate to severe.

Symptoms: From being completely benign to causing severe pain, endometriosis can present itself in varying ways. The implanted tissue can be minimal like a small lump to large clumps. The symptoms are not dependent on the size of the implanted tissue, however, 

1. Painful menstruation: One of the most common causes of non-menstrual cramps, the pain is different from usual menstrual pain, starts a few days before the period and can last up to after the period.

2. Pelvic pain: One of the most common causes of pelvic pain, this can happen wherever the implanted tissue is. In severe cases, this tissue can also bind different organs, forming what are called adhesions. The bladder or the bowels may adhere to the uterus. These are more painful than individual lumps of tissue outside the uterus.

3. Intermenstrual bleeding: There could be spotting to severe bleeding between the regular cycles.

4. Painful sex: There is a deep pain within the pelvis and it can lead to losing interest in sex.

5. Infertility: The most severe symptom and complication is not being able to become pregnant.

Diagnosis: A detailed patient history, discussion on symptoms followed by ultrasound and laparoscopy can help in diagnosing endometriosis.

Treatment: If there is no symptom and fertility is not an issue, then it is possible that no treatment is required. However, depending on symptoms and complications, the following are done.
- If pain is the only main problem, painkillers are administered
- Surgical treatment may be required if there is severe bleeding and adhesions complicating the situation. 

This will also relieve other symptoms
1. Hormone therapy is also an option for treating endometriosis.
2. If you are having pelvic pain and irregular bleeding, bring it up with your doctor. Even if it is not endometriosis, a thorough check up will put your mind at rest.

Endometriosis and Complications Associated With It

Endometriosis is a painful disorder in which tissue that normally lines the inside of your uterus, the endometrium grows outside (endometrial implant). It commonly involves ovaries, bowel or tissues lining your pelvis. The main symptoms are pelvic pain and infertility. While chronic pain exists throughout, it tends to aggravate during menstruation and / or sex. Though the cause is not entirely clear, women with a family history of the condition need to be extra cautious. Endometriosis is normally detected by its symptoms combined with a medical imaging. Though the growth is not generally cancerous, a biopsy is recommended to eliminate doubts. 

The condition of endometriosis is attached with social and psychological effects as it affects a woman's child bearing ability. Most minds race anxiously as to what the surgeon might find and will your body heal after the procedure. Here are some tips to prepare for your endometriosis laparoscopy

 Before the surgery: read up as much as possible about your condition and note down questions you want to ask your doctor. Get details about the entire procedure and how the doctor is treating your specific case. Having knowledge will help you stay calm and focused. Next, gear your home for the process. Stock your fridge with quick heat home made meals. It's best for you and the family to have healthy food than the store bought preservative laden food. Clean your home, change your sheets and purchase some loose fit clothing for later use. Last but not the least, stock up on some reading material that will come handy during your rest period. 
 On day of surgery: do not eat or drink anything from 12 midnight until the time of your surgery. You may also need the unpleasant enema procedure during your prep. Remove your nail polish and leave your jewellery, watch and valuables at home. Shower and get to the hospital early to get on with the forms you'll need to fill. The procedure requires anesthesia so do discuss your allergies or any concerns you may have with this aspect of the procedure. Once you are set with you iv and anesthesia, the doctor takes over to do what they do best cure you.
 The procedure: a small incision is made near the belly button and the abdomen is filled with co2 gas which lifts it away from other organs. During the laparoscopy, the doctor examines the pelvic organs, looking for obvious and atypical endometriosis lesions as well as endometriomas (endometriosis'filled cysts, adhesions, and scarring. He may then remove the lesions to send to a lab for biopsy
 After surgery: you'll most likely wake up groggy in the recovery room after your surgery. You may feel some pain as you come around but if it's a day procedure, you'll be able to leave as soon as you feel ready. 

Although pregnancy may temporarily suppress the symptoms of endometriosis, it does not eradicate the disease. The symptoms will almost always return after the baby is born. If you are suffering from this painful condition and want to seek help, you can consult here.

How To Prepare For Your Endometriosis Laparoscopy

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.
Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

Medication: It usually involves painkillers.
Hormone therapy: Some of the hormonal therapies include:
Hormonal contraceptives
Progestin therapy
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Endometriosis - 4 Reasons Behind it!

When endometrial tissue that usually grows inside the uterus, starts growing outside uterus, it is called Endometriosis. Pain during or before periods, pain during intercourse, pain while urinating or bowel movements, heavy bleeding, infertility are some of the symptoms of endometriosis.

Treatment of endometriosis usually depends on the following factors:

Age of female
Severity of symptoms
Duration of the symptoms
Future plans for children/ fertility
Associated pathologies
Accordingly the doctor might choose any of the treatment options like:

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain  relieving medications like Nonsteroidal anti-inflammatory drugs (e.g. Diclofenac) or anti-spasmodics(e.g.drotaverine)
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
Medroxyprogesterone: This helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
Gonadotropin-releasing hormone (GnRH) agonists: Gonadotropin hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence symptoms. It can cause absence of menstruation in some females which is reversible.
Danazol: It is synthetic androgen, suppresses growth of endometrial tissue temporarily.  However, Danazol may not be a favourable option because of its side effects. Females should avoid pregnancy while on this drug.
Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
Conservative surgery: If you are trying to conceive, then surgical excision or ablation of endometrial tissue is one treatment option.Suboptimal surgery with conservation of maximum ovarian tissue is considered suitable in such cases.
Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.

Endometriosis - Ways To Manage It Well!

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