More than ten percent of American women suffer from endometriosis, a condition that causes tissues of the uterine lining (endometrium) to grow outside of the uterus. The tissues commonly develop in the fallopian tubes, ovaries, and pelvis – although they can also spread to areas like the vagina, cervix, and rectum.
Endometriosis can come with a host of side effects like painful menstruation and pelvic cramping. What's more, about one-third of women with endometriosis have trouble getting pregnant, and those who successfully conceive have a higher risk of miscarriage, preterm delivery, C-section, preeclampsia, and other complications. Not all hope is lost for prospective parents, though: Certain medications, fertility treatments, and surgery may help those with endometriosis have happy, healthy pregnancies.
Here’s everything you know to know about getting pregnant and delivering a baby while affected by endometriosis.
According to UCLA Obstetrics and Gynecology, about 20% to 40% of women with endometriosis deal with infertility, or the inability to conceive despite having regular unprotected intercourse. In fact, endometriosis is one of the leading causes of undiagnosed infertility today, says Karli Goldstein, M.D., a gynecologic surgeon at Seckin Endometriosis Center. A 2014 study published in PMC found that women with endometriosis have a 2–10% chance of conceiving each month, compared with a 15–20% chance for those without the condition.
So why does infertility sometimes come with endometriosis? One reason may be that inflammation blocks the fallopian tubes and ovaries, preventing an egg from coming into contact with sperm. A fertilized egg (embryo) may also have trouble implanting into the uterus wall. Finally, endometriosis can damage the egg or sperm itself, according to the Endometriosis Foundation of America.
Remember, however, that not every woman with endometriosis has trouble conceiving. Infertility could have many other causes, including ovulation disorders like polycystic ovary syndrome (PCOS), advanced maternal age, fallopian tube blockage, and uterine fibroids.
Can You Treat Infertility Caused by Endometriosis?
If a woman wants to combat endometriosis-induced infertility, she can try treating the endometriosis itself. This is usually done with laparoscopic excision surgery, which will remove endometrial tissue through a small incision in your abdomen, according to Mayo Clinic. Fertility treatments, such as in vitro fertilization (IVF) and intrauterine insemination (IUI), can also increase your odds of conceiving. Talk to your doctor for more information.
If a woman with endometriosis conceives, the pregnancy will likely go without a hitch. However, there’s a higher rate of miscarriage among endometriosis patients, says Masahide Kanayama, M.D., an endometriosis specialist at The New York Endometriosis Center. Endometriosis also raises your risk of other pregnancy complications. According to Dr. Goldstein, these include preterm delivery, placenta previa, cesarean section, preeclampsia, and gestational diabetes. You may also experience bleeding in the second and third trimesters.
While there’s no cure for endometriosis, some women report that symptoms subside during pregnancy because of a rise in the hormone progesterone. But these improvements aren’t permanent, and symptoms usually appear again after a woman’s period returns postpartum (or after she stops breastfeeding). Other women experience exaggerated endometriosis symptoms during pregnancy; this is likely because the growing uterus irritates the misplaced uterine tissues.
Pregnant women can manage endometriosis pain with lifestyle changes, such as improved exercise routines and nutrition, says Dr. Goldstein. Over-the-counter pain relievers, heating pads, and natural remedies like herbal supplements and acupuncture may also help. Talk to your doctor before implementing these relief measures while pregnant.
After the baby is born, a woman can return to her normal endometriosis pain management technique, whether it’s hormonal therapy, birth control pills, or pain medication. Laparoscopic excision surgery is also an option.