I have endometriosis… What should I do?
Endometriosis is a relatively common pathology in women, and in some cases it may affect their fertility
Nearly one out of every ten women at a fertile age suffers from endometriosis. This is a relatively common disease in which the endometrial tissue develops and grows outside the uterus. In some cases, depending on the severity of the damage, it may lead to problems of fertility in women.
There is no single symptom that tells a woman she has endometriosis. Although there may be a certain amount of discomfort (pain in the lower abdomen during the menstrual cycle and menstruation and pain during sexual intercourse), many women who suffer from endometriosis do not develop those symptoms. Consequently it is quite usual for this disease to go undiagnosed until a specialist is consulted after failing to become pregnant.
In each case, treatment will depend on the severity, the patient’s age and her wish to become pregnant. So while in some cases surgery may be necessary to remove cysts and implants, in other cases it is sufficient to administer treatment –such as contraceptives– to block the ovary function and prevent the endometriosis from continuing to develop.
A natural pregnancy is possible
“Endometriosis is not synonymous with sterility”, says Dr. Clara Colomé, gynaecologist and specialist in assisted reproduction. “If a women affected by this pathology wants to become pregnant, she can try to conceive in a natural way. If after a certain length of time (six months in women aged over 35 and one year in women aged under 35) she does not become pregnant, then this is the time to consult a specialist”, she assures.
Endometriosis may have a direct effect on a woman’s fertility. In particular, this situation occurs in three out of every ten women who develop the disease. “It is difficult to become pregnant for two reasons: either because the endometriosis itself reduces the number and quality of the woman’s eggs”, explains Dr. Colomé, “or because it distorts the anatomy of the woman’s pelvis, altering the functions of the tubes and making it difficult for a pregnancy to occur”, she adds.
In such cases –after analysing each specific situation- an assisted reproductive treatment will be carried out: either artificial insemination or in vitro fertilisation. The latter treatment is more frequent in cases of advanced endometriosis in which the damage is more severe.
Egg freezing: a preventive option
Given that endometriosis may impair a woman’s fertility –by prematurely reducing the quality of her eggs or after surgery to treat the condition– egg freezing may be a recommended option after diagnosis at an early age and if the woman is not yet ready to be a mother.
At present there is no scientific evidence to explain the development of this disease. However, the appearance of its symptoms does not necessarily mean the woman is suffering from the disease or that it is a more severe condition. “In all cases, in the event of any of the symptoms of the disease developing, the first thing to do is to consult a specialist in order to rule out the possibility of those symptoms being due to other causes”, concludes Dr. Colomé.