Unfortunately, in many women with endometriosis the desire for children remains unfulfilled: more than half of all patients can not spontaneously get pregnant. The best treatment in this case is surgery, experts say. The surgical removal of the endometriosis herd can improve fertility in many women. Read all important information about endometriosis and the desire to have children and in which cases artificial insemination is recommended!
Endometriosis: reasons for unfulfilled desire for children
Endometriosis and infertility often go hand in hand: more than half of women with endometriosis have problems getting pregnant. Conversely, the disease is found in more than 50 percent of all women with unfulfilled desire for children.
The causal relationship between endometriosis and infertility has not yet been elucidated in detail. One thing is certain: endometriosis can Adhesions and adhesions of the fallopian tubes and ovaries cause a “mechanical” obstacle to pregnancy.
It is unclear whether the endometriosis foci – which are a foreign body to the organism (uterine lining in the wrong place) – cause the immune system to act in a way that prevents the functioning of a fertilized egg. It is also unclear whether endometriosis affects the migration of sperm through the uterus and fallopian tube, oviduct mobility and egg maturation. However, there are indications that egg development and early embryonic development may be disturbed in endometriosis patients.
Notes: Endometriosis may also be associated with infertility if the condition does not cause any discomfort!
Pregnant despite endometriosis – thanks to surgery
If in women with endometriosis the desire for children remains unfulfilled, one should Surgically remove endometriosis foci, as complete as possible. This can improve the chances of a spontaneous pregnancy, at least with pronounced endometriosis. In mild cases, if the fallopian tubes and ovaries are not affected by growths of the lining of the uterus, it is not certain whether surgery can help: in such cases, it is questionable whether the unfulfilled desire to have a baby is actually caused by endometriosis.
An endometriosis surgery will usually as a laparoscopy (Laparoscopy): The surgeon introduces an endoscope into the abdomen via a small incision in the abdominal wall. This is a thin tube with a small camera and a light source at the top. This tube can be used to introduce fine surgical instruments that can be used to remove endometrial implants and cysts.
Endometriosis drugs do not help
Endometriosis is sometimes treated with medications instead of surgery: hormone preparations containing progestins or GnRH analogs can slow down the growth of endometriosis foci and so relieve the pain of the disease. However, this purely medicinal endometriosis treatment has no influence on fertility.
The same applies to treatment with GnRH analogs after an endometriosis operation: The hormones are supposed to calm remaining endometriosis foci. So far, however, there is no evidence that the combination of surgery and hormone treatment is more effective than surgery alone: it does not help better against the pains of endometriosis, and pregnancy is not more likely to become a combination therapy. In addition, the hormone preparations may have unpleasant side effects (hot flashes, sleep disorders, mood swings, etc.). Experts therefore advise against postoperative GnRH treatment in endometriosis patients with infertility.
Endometriosis: Artificial insemination
Especially with a pronounced endometriosis often form new scattered mucosal islands after surgery (relapse = recurrence)). However, experts advise against further surgery to improve fertility – especially if the woman has already undergone several such operations. Instead, they recommend artificial insemination for recurrent endometriosis. The desire to have children is more likely to be fulfilled than with further operations.