Endometriosis affects about 10% of reproductive age women. It’s a problem we see frequently here at Desert Hills Care Center in Las Vegas, Nevada, and patients often have concerns about the condition’s effects on their fertility.
Our board-certified OB/GYN, Helard Ballon-Hennings, MD, FACOG, explains that endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. This tissue causes inflammation and scarring that can lead to severe pelvic pain and make conception more difficult.
With Endometriosis Awareness Month highlighting the need for education, it’s a great time to discuss how managing endometriosis can also mean preserving fertility.
Endometriosis can interfere with conception in several ways:
Endometrial adhesions (bands of scar tissue) may form in or around the fallopian tubes, preventing eggs from traveling to the uterus.
Chronic inflammation can damage eggs and interfere with implantation.
Disruptions in your hormone levels can affect ovulation and egg quality.
Severe cases of endometriosis may lead to structural changes that make natural conception harder.
Talking about fertility preservation early, before surgery or treatment for endometriosis, is vital to prevent disappointment in the future should you want to start a family.
Understanding your options allows you to make decisions that align with your current family-building goals or ensure that you have the opportunity to conceive at a later date if you haven’t any firm plans now.
When deciding on treatment, it’s important to consider the severity of endometriosis, personal reproductive goals, and potential risks to ovarian function.
In some cases, surgery can improve natural fertility, especially for mild to moderate endometriosis. However, for those with advanced disease, surgeries (especially if repeated) may lower ovarian reserve and make conception more difficult.
Talking with Dr. Ballon-Hennings about how different treatment options affect fertility can help you make informed choices. Some women may choose surgery to relieve unbearable pain, while others may prioritize preserving eggs or embryos before undergoing treatment.
If you’re concerned about your ability to conceive following endometriosis treatment, several fertility preservation methods can help:
This option involves retrieving and freezing unfertilized eggs for future use. This is a good option for women who aren’t ready for pregnancy but want to safeguard their fertility.
This option is similar to egg freezing, but the eggs are fertilized after retrieval, then frozen as embryos.
Egg and embryo freezing begin with the same process, ovarian stimulation. This requires you to take synthetic hormones that activate your ovaries so they produce multiple eggs. When it’s time for egg retrieval (usually after 10-14 days), a human chorionic gonadotropin (hCG) injection helps the eggs mature.
The next stages are:
Egg retrieval takes place while you’re under sedation. A typical technique is transvaginal ultrasound aspiration, during which your provider inserts a slender ultrasound probe into your vagina to identify the egg follicles. They then guide a needle through your vagina to a follicle, removing multiple eggs with a suction device.
Soon after harvesting, your unfertilized eggs undergo cooling to subzero temperatures. High concentrations of substances called cryoprotectants stop ice crystals from forming, which would damage the eggs.
If you opt for embryo freezing, the lab mixes the harvested eggs with your partner’s sperm first and then freezes the resulting embryos for later use.
When you want to conceive, your provider thaws embryos (or thaws the eggs and fertilizes them) and implants them in your uterus.
In vitro fertilization (IVF) is when sperm fertilize eggs outside the uterus, producing an embryo for implantation. You’ll undergo IVF if you opt to freeze your embryos or eggs.
For those with mild to moderate endometriosis, intrauterine insemination (IUI) might be an option. It can increase pregnancy chances by placing sperm directly into the uterus via a thin tube (catheter), bypassing some barriers caused by scarring.
You can undergo IUI as the only treatment or take fertility drugs first to optimize egg production. IUI is less invasive and cheaper than IVF, but it typically has lower success rates.
Endometriosis doesn’t automatically mean infertility, but it does require careful management. Fertility-preserving treatments, surgery, and assisted reproductive technologies could all play a part in helping people with endometriosis achieve their dreams of pregnancy and parenthood.
Call us at Desert Hills Care Center or send us an online inquiry if you have concerns about the effects of endometriosis and its treatment. Open conversations and early planning can make all the difference in protecting fertility for the future.
