Every woman desires to experience the sweetness of motherhood but unfortunately, some fail to get it. It is because either they have low fertility or because they have developed a disease or disorder like endometriosis and Polycystic Ovary Syndrome (PCOS) due to which they fail to conceive.

Endometriosis is always associated with infertility. To get relief from troublesome problem is to get pregnant earliest may be by IUI if tubes are patent or by IVF. Endometriosis is conditions which lead the womb cells (endometrial cells) to develop in other parts of the body because of which women experiencing this disease fail to release the menstrual blood and also fail to conceive. But these days nothing is impossible it this medical advancement era. There are many ways and methods by which one can conceive.

So here we are providing a useful set of information on some of the best Fertility treatments.

Intrauterine Insemination or Artificial Insemination: It is a normal process in which the sample of a prepared sperm from the husband or the partner is injected directly into woman s uterine cavity during ovulation.
In Vitro Fertilization: In this process, specific medication is used for the stimulation of the ovaries which lead them to produce more eggs in a while. Then eggs are then removed and fertilized with the husband or partner s sperm in a laboratory. The fertilized eggs are placed for 3-5 days to develop an embryo and then the embryo is transferred to woman s uterus.
It is considered as one of the best and last stop infertility solution which proves to be a boon for a sterile couple. As in this process, fertilization takes place outside the body because of which there is no problem of conception even in the condition of any blockage and also minimizes the risk of endometriosis-related infertility. The endometriotic deposits produce and releases toxin into the uterus, fallopian tubes and ovaries thus the egg gets toxic and fail to fertilize the sperm. 

In such condition, many patients rush for many other infertility treatments like fertility medications, intrauterine insemination, etc and when they lose hope of getting the desired result then they find a ray of hope by this ultimate treatment. There are five times more chances of conceiving by this method regardless of the age of women and the stage of endometriosis. The treatment is a boon not only for woman grappling with endometriosis but also for other critical issues like severe male infertility factor, blocked fallopian tubes, and reduced ovarian reserves. In such cases instead of wasting the money on other treatments doctors advice for IVF.

IVF minimizes the chances of miscarriage and also increases the chances of having a healthy baby. So if you are grappling with any such infertility issue than this informative guide may aid you in the journey from infertility to hearing child squeal at your home.



Endometriosis - How IVF Is Beneficial In This Case?

What is Endometrium?

The uterus is where the fetus grows and develops. It has three linings- the outermost lining, the middle layer and the innermost lining. The innermost layer is called Endometrium. The endometrium is made of mucosal tissues.

How the endometrium changes and what is its function?

Before ovulation, when an egg is released, the functional layer of the endometrium undergoes a change. Vascularization takes place i.e. a buildup of blood vessels and tissues that thickens the endometrium in anticipation of implantation of a fertilized egg. If conception does not take place, the tissues and cells are shed from the endometrium lining. This is when a woman gets her period.

When conception does take place, the fertilized egg attaches itself to the endometrium. The endometrium also supports the placenta, which provides the fetus with oxygen and nutrition.

What is the ideal thickness of the endometrium?

In pre-menopausal women, the thickness of the endometrium should be-

  Between 2-4 millimetres during menstruation,
  5-7 millimetres at the onset of the early proliferative phase
  Around 11 millimetres during the late proliferative phase
  16 millimetres during the secretory phase



What is a poor/thin endometrium?

If the endometrium lining does not meet standard thickness and is not conducive to implantation, it is called a poor endometrium.

Causes behind thin endometrium

There could be many reasons that can lead to a poor endometrial layer-

  Inadequate secretion of estrogen
  Insufficient blood flow
  Prolonged use of birth control pills
  Substandard quality of endometrial tissues
  Presence of fibroids (small uterine tumours)
  Amenorrhea (unnatural periods/ excess bleeding or too little bleeding)
  Intrauterine adhesions (scar tissues form between the layers of the uterus and glue them together)
  Pelvic inflammatory disease
  Use of clomiphene

What are the symptoms of poor endometrium?

  Infertility (inability to conceive)
  miscarriage
  Irregular menstruation
  Painful periods
  Inadequate bleeding during menstruation

Treatment for poor endometrium

  Since the most common cause of poor endometrium is insufficient estrogen, doctors prescribe estrogen pills that can raise estrogen levels.
  If poor endometrium is the result of poor blood flow, an Ultrasonography Test will reveal that. Then doctors prescribe Vitamin E pills and L-arginine amino acid pills to thicken the endometrium layer.
  Regular exercising increases blood flow to the uterus
  Acupuncture is a very effective stress buster. Chronic stress could lead to a shrunk uterine wall. Acupuncture can allay the stress and promote the health of the uterus.
  Intrauterine adhesions can be extracted through surgery.
  Natural remedy (through natural therapy) includes asparagus, royal jelly, cover and they help in thickening the endometrium layer.
  Granulocyte Colony Stimulating Factor if injected into the body raises endometrial thickness and combats infertility.

Only an endometrium of normal thickness can support a pregnancy. If the lining is not thick enough medical intervention may be necessary.

Poor Endometrium - Can It Be Treated?

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!

What is endometriosis?

Endometriosis is a common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes. It mainly affects women during their reproductive years. Endometriosis is not an infection and it is not contagious.

What are the symptoms?

The main symptoms of endometriosis are pelvic pain, pain during or after sex and painful, sometimes heavy periods. It may cause problems with getting pregnant. It can affect many areas of a woman s life including her general physical health, emotional wellbeing and daily routine. Many women may have no symptoms. It is a long-term condition. Some women with endometriosis become pregnant easily while others have difficulty getting pregnant.

What causes endometriosis?

Endometriosis occurs when the cells of the lining of the womb are found in other parts of the body, usually the pelvis. Each month this tissue outside the womb thickens and breaks down and bleeds in the same way as the lining of the womb. This internal bleeding into the pelvis, unlike a period, has no way of leaving the body. This causes inflammation, pain and damage to the reproductive organs. Less commonly, endometriosis may occur on the bowel and bladder, or deep within the muscle wall of the uterus (adenomyosis). It can also rarely be found in other parts of the body.

The symptoms of endometriosis are common and could be caused by a number of other conditions such as irritable bowel syndrome (IBS) and pelvic inflammatory disease (PID).

There is no simple test for endometriosis.
Your gynaecologist may examine your pelvic area, this will include an internal examination.
You may be offered a scan. This can identify whether there is an endometriosis cyst in the ovaries. A normal scan does not rule out endometriosis.
For most women, having a laparoscopy is the only way to confirm endometriosis; because of this, it is often referred to as the  gold standard  test. This allows the gynaecologist to see the pelvic organs clearly and look for any endometriosis.
Several factors may influence your decision about treatment. These include:

How you feel about your situation
Your age
Whether your main symptom is pain or problems getting pregnant
What treatment can I get?

The options for treatment may be:

Pain relief

Hormone treatments: There is a range of hormone treatments to stop or reduce ovulation (the release of an egg) to allow the endometriosis to shrink or disappear. The hormonal methods below are contraceptives and will prevent you from becoming pregnant:

The combined oral contraceptive (COC) pill or patch. These contain the hormones estrogen and progestogen and work by preventing ovulation and can make your periods lighter, shorter and less painful.
The intrauterine system (IUS): this is a small T-shaped device which releases the hormone progestogen. This helps to reduce the pain and makes periods lighter. Some women get no periods at all.
The hormonal methods below are non-contraceptive, so contraception will be needed if you do not want to become pregnant:
Use of hormonal progestogens or testosterone derivatives
GnRH agonists are drugs that prevent estrogen being produced by the ovaries and cause a temporary and reversible menopause.
Some women find that recreational exercise improves their wellbeing, which may help to improve some symptoms of endometriosis.

Surgery: Surgery can be used to remove areas of endometriosis. There are different types of surgery, depending on where the endometriosis is and how extensive it is. How successful the surgery is can vary and you may need further surgery.

Laparoscopic surgery: The gynaecologist removes patches of endometriosis by destroying them or cutting them out.
Laparotomy: If the endometriosis is severe and extensive, you may be offered a laparotomy. This is major surgery which involves a cut in the abdomen, usually in the bikini line.
Hysterectomy: Some women have surgery to remove their womb (a hysterectomy) with or without the ovaries. Depending upon your own situation, your doctor should discuss hormone replacement therapy (HRT) with you if you have your ovaries removed.
What if I am having difficulty getting pregnant?

Getting pregnant can be a problem for some women with endometriosis. Your doctor should provide you with full information about your options such as assisted conception. If you become pregnant, endometriosis is unlikely to put your pregnancy at risk.

Endometriosis - Signs & Symptoms That Indicate It!

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

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