1 woman in 10 suffers fromendometriosis. In addition to the incapacitating daily pain and moral suffering that endometriosis causes, this disease also has an impact on pregnancy. How can endometriosis and the desire for pregnancy be managed? What impact does endometriosis have on the pregnant woman? How does endometriosis affect pregnancy? We shed light on several points in this article.
Is it possible to become pregnant with endometriosis?
Endometriosis can indeed make it more difficult to get pregnant. However, some women manage to become pregnant naturally even though they have this disease.
Does endometriosis cause infertility?
Clinical studies show that there is a link between endometriosis and fertility. According to EndoFrance, 30 to 40% of women with endometriosis haveinfertility problems. There are several reasons why women with this gynecological condition have difficulty conceiving a child the inflammatory state of the endometrium can disrupt the relationship between the spermatozoa and the oocyte disorders of ovulation and the reproductive organs the decrease in the follicular reserve and its cells the appearance of adhesions that will compress or even block the tubes, which will prevent fertilization the development of endometriotic cysts in the ovaries will prevent the follicles from forming correctly. in some women, endometriosis causes pain during sexual intercourse (dyspareunia), so the absence of regular sexual intercourse can complicate the pregnancy project irregular periods and disturbances in the menstrual cycle that can complicate the calculation of the ovulatory period adenomyosis
How does a pregnancy with endometriosis work?
With pregnancy, hormonal fluctuationsare predominant. Hormonal impregnation, in particular of estrogens, will therefore evolve over the course of the pregnancy.
Worsening of symptoms in the first trimester
During the first trimester of pregnancy, the symptoms of endometriosis may becomemore pronounced. Pain, menstrual cramps, discomfort or discomfort may continue to punctuate your daily life, even in the absence of a period.
Symptoms subside or even disappear until after the birth
On the other hand, a few weeks later, the symptoms diminish or even disappear completely until after thebirth. Indeed, the estrogen level will decrease when the woman is pregnant, so the lesions of this gynecological condition will be less painful. Progesterone levels will increase, which will ease the pain. Endometriosis after pregnancy will most certainly reappear and the symptoms with it.
What are the complications of a pregnancy with endometriosis?
In addition to causing infertility in certain women throughout their menstrual life and until the menopause, endometriosis will increase the risk of complications during pregnancy. For example, the risk of early miscarriage is increased by 10%. Similarly, there is an increased risk of prematurity and very prematurity, a risk of placenta previa (abnormality of the implantation of the placenta), and a risk of delivery by caesarean section (particularly if there has been surgery to treat this disease in the past, making natural delivery more complicated). Finally, the risk of having an ectopic pregnancy is increased with endometriosis. Of course, not all pregnancies are pathological; some women with endometriosis become pregnant without complications.
If you encounter problems during your pregnancy, consult your doctor who will give you the appropriate treatment or medication.
What are the solutions to promote pregnancy with endometriosis?
For women suffering from this disease and unable to become pregnant, there are several solutions.
One of the first solutions is surgery, which consists of destroying or removing the endometriosis lesions that prevent pregnancy. But be careful, laparoscopic surgery depends on the nature of the condition, its extent, the location of the lesions, and other factors. Imaging (ultrasound, MRI) is first performed to determine if the operation is feasible. This is not a 100% reliable solution because, depending on the endometriosis, the lesions may reappear. The advice of a health professional and an examination is necessary.
Medically assisted procreation
When a couple is unable to conceive a child, an infertility assessment is performed to determine the causes of the infertility. For some couples, endometriosis and infertility are sometimes unrelated! Depending on the results of the diagnosis, MAP (medically assisted reproduction) solutions will be provided:
- ovulation stimulation or ovarian stimulation
- artificial insemination, which consists of introducing spermatozoa into the uterus
- conventional in vitro fertilization (IVF ) or IVF with micro-injection of sperm into the oocyte. Sometimes IVF is preceded by a pre-treatment with estrogen-progestin or GnRH agonists.
For women with endometriosis who do not wish to have children immediately, it is possible to freeze their oocytes. Indeed, this gynecological disease, its effects and the surgeries that the patient can potentially undergo, can interfere with the ovarian reserve. You can contact your doctor, gynecologist or midwife who will be able to guide and advise you.
FAQ on pregnancy with endometriosis
Does endometriosis prevent me from getting pregnant?
Endometriosis does not prevent you from getting pregnant but it can cause infertility and irregular periods. Infertility should not be confused with sterility. Early diagnosis and medical follow-up are the key to a well-informed baby project!
Can you have a normal pregnancy with endometriosis?
Even though some women may have pregnancies with complications linked to their endometriosis, this is not systematic and it is possible to have a baby and be pregnant normally even if affected. Each endometriosis, each stage and each woman is different.