Fertility issues are on the rise in both men and women. Multiple factors contribute to fertility problems and make it difficult to conceive on their own. Women suffer from some common fertility disorders like PCOD, fallopian tube block, endometriosis, etc. Thanks to the advances in assisted reproductive technology, which is a lifesaver, aiding in getting pregnant when you suffer from fertility issues. In vitro Fertilization (IVF) is one such assisted reproductive technology that helps couples to enter parenthood. If you face difficulty in conceiving on your own due to endometriosis, IVF is a reliable option to conceive. Continue reading for a clear update on IVF for endometriosis.
Endometrium is the innermost lining of the uterus where implantation of embryo takes place. In endometriosis tissue similar to endometrium grow outside the uterus affecting fallopian tube, ovaries, pelvic cavity, urinary bladder, bowels, lungs or very rarely even in the brain. It affects 10-15 % of women and girls in the reproductive age group. Women with endometriosis may experience severe dysmenorrhea, chronic pelvic pain, pain with intercourse, infertility, etc. Nearly 25-40% of infertile women are affected with endometriosis.
Endometriosis is a condition that greatly impacts fertility and interferes with conception. You may be aware of the growth of endometrial tissue during the menstrual cycle. During your period, these tissues will be shed if you do not suffer from reproductive problems. Women with endometriosis the development of same endometrial tissue occurs on other organs, which is not shed during menstruation, as happens with the uterus. This results in cyclical collection of blood at the ectopic endometrial tissue resulting in inflammation, scar tissue and the formation of cysts. In turn, results in women experiencing intense pain during menstruation due to endometriosis.
Inflammation due to endometriosis can result in anatomical distortions in the fallopian tube (where the fertilization of egg with sperm happens) leading to blockage of the tubes along with production of low egg quality and creating an inhospitable environment for the entry of sperm inside the uterus and fallopian tubes. Miscarriage and implantation failure are the other risks associated with endometriosis in women.
Advanced stage (III-IV) endometriosis has significant reduction in live births.
The treatment of endometriosis depends on the stage of the disease and, also, the characteristics of the couple seeking treatment. In women with minimal to mild endometriosis chances of successful spontaneous pregnancy is good after surgical treatment of endometriosis. The success rate is better when the couple undergoes intra uterine insemination than trying for natural pregnancy.
In women with moderate to severe disease invitro fertilization with surgery and prolonged suppression of endometriotic activity with gonadotropins has shown better success rate. When endometriomas (endometriotic cyst within ovary) are present surgical excision is advised. This may result in reduction of eggs and decreased response to ovarian stimulation for IVF. Deep endometriosis requires complex surgeries with considerable risks.
IVF includes several steps, and you may undergo several cycles for a successful conception. Before starting the IVF process, your doctor will ask you to go for several tests to assess the quantity and quality of eggs.
● The first step in IVF is stimulating the ovary to produce more eggs and improve egg quality. This is done by injecting an ovarian-stimulating hormone before the ovulation period.
● Your doctor may prescribe additional medicines to suppress the estrogen levels as higher levels of estrogen may worsen endometriosis.
● The next step is to retrieve the egg from the ovary. A long needle is inserted vaginally that picks the eggs from the ovarian follicles. The sperm from your partner is also collected.
● Now, the egg and the sperm are allowed for fertilisation in a laboratory setting, which increases the chances of fertilisation.
● Successful fertilisation causes the embryo to grow and reach the blast stage. If two or more embryos are fertilised, a healthy one is chosen for implantation.
● Now the embryo is transferred back into the uterus vaginally.
● If the embryo successfully implants in the uterus lining, you are pregnant.
● You will be asked to undergo a blood test after two weeks to confirm pregnancy.
● There are chances of conceiving in the first IVF cycle; if not, you will be asked to repeat the IVF cycle.
You must be aware of the success of endometriosis and IVF before you undergo the same. Success rate of IVF in women with endometriosis is slightly lower. The severity of endometriosis can reduce the chance of conception through IVF. A study suggests that profoundly inflated endometriosis can lower the success rate of IVF when compared with endometriosis with mild symptoms.
Though IVF is usually recommended for women with endometriosis, it is also associated with certain risks. It is said that IVF can worsen the symptoms of endometriosis as the estrogen hormone used for IVF medications can increase the growth of endometriosis. This can result in inflammation and severe endometriosis. There are also chances of rupturing the endometrial cysts when retrieving eggs which can lead to pelvic abscess of sepsis. But this is rare occurence.
Consult a fertility specialist to learn more about endometriosis and IVF implantation. Your doctor will recommend treating endometriosis or starting with IVF based on the test assessments.
The overall success of IVF for endometriosis will vary depending on the health condition of the individual and how their body can accept the procedure. The severity and the stage of endometriosis is also a crucial factor in determining the success rate. In case of any doubts, clarify with your medical practitioner before you go for the procedure.
Many women with endometriosis successfully get pregnant through IVF. In most cases, the symptoms of endometriosis do not affect the IVF fertility treatment. However, the severity and stage of endometriosis can lower the success rate of IVF.
You can continue with IVF without removing endometriosis, but treating endometriosis before IVF can help in increasing the success rate of IVF.
Best treatment protocol is individualized based on the couple characteristics and stage of the disease.
Endometriosis affects egg quality, impacting fertility in women. Few supplements have been seen to be beneficial but non to be of proven efficacy.
