GETTING PREGNANT WITHENDOMETRIOSIS: FERTILITY FACTS

Many women with endometriosis are able to conceive, and help is on hand for those navigating endometriosis and fertility.

One of the biggest concerns for those diagnosed with endometriosis is how the condition might affect their chances of having a baby. But the reassuring fact is that the majority of women with endometriosis do have successful pregnancies.

And there’s more help than ever on hand for those navigating endometriosis and fertility.

As part of the 2022 budget, the Australian government announced specialised endometriosis and pelvic pain clinics are to be established in every state and territory to improve diagnosis, care and treatment for the 800,000-plus Aussie women who live with endometriosis.

Why is it hard for some women to get pregnant with endometriosis?

Complications caused by endometriosis can include blockages in the fallopian tubes, scarring of the tubes and ovaries, and pelvic inflammation – all of which can make conception challenging.

“Endometriosis, whether mild or severe, can affect fertility by distorting the reproductive organs and disrupting ovulation with endometriotic ovarian cysts,” says fertility specialist and endometriosis expert Dr Raewyn Teirney. "With endometriosis, certain chemicals are released that can cause inflammation and scarring. This will then obstruct the interaction between sperm and egg, and potentially prevent an embryo from implanting in the uterine wall."

While it’s true that endometriosis can cause fertility struggles, “in most cases we can successfully treat women to go on and have a happy, healthy baby”, Dr Teirney reassures.

In fact, the National Action Plan for Endometriosis found that only 1 in 3 women with endometriosis will face fertility challenges as a result of the disease.

Donna Ciccia, director and cofounder of Endometriosis Australia concurs. “While some women with endometriosis may have trouble conceiving, many will go on to have a baby, despite complications resulting from the disease.”

How to get pregnant with endometriosis

When it comes to endometriosis, no 2 cases are the same. It’s a highly individual condition, with symptoms differing from person to person.

"The scarring caused by endometriosis can lead to a distorted or blocked fallopian tube, making it impossible for that tube to pick up an ovulated egg," says Dr Teirney.

Treatments that may improve fertility include fertility medication coupled with the medical insertion of sperm directly into the uterus, and IVF. Laparoscopic (keyhole) surgery can also be used to diagnose and treat the condition. This is minimally invasive and performed under a general anaesthetic.

“[With laparoscopic surgery] we make a small incision on the navel and insert a camera into the abdominal cavity. From here, we can identify the presence of endometrial tissue and also treat it then and there” says Dr Teirney.

For many women, this might be the only treatment required to boost fertility and improve their chances of natural conception.

“For those who require IVF treatments, this surgery certainly improves success rates,” says Dr Teirney.

Support for endometriosis

Donna says that while it can be difficult for the roughly 30% of women with endometriosis who face fertility challenges, Endometriosis Australia and other support organisations like QENDO and EndoActive are there to help women manage their condition and help improve quality of life, regardless of how mild their endometriosis might be.

“I think there’s a lot of scary information out there about endometriosis and fertility and it’s important not to panic,” she says.

The important thing to remember is that an endometriosis diagnosis doesn’t necessarily mean that having a baby will be impossible, or even difficult.

Women with endometriosis or at risk of endometriosis who are concerned about their fertility should start by talking to their doctor before engaging with a fertility specialist.

Will getting pregnant cure endometriosis?

Many Aussie women believe having a baby is one of the reliable treatments, or even possible cures for endometriosis. The advice to ‘go away and have a baby’ was common in the 1950s and 1960s, but we now know that it was based almost entirely on reports of women whose endometriosis improved during pregnancy. There is no widely accepted evidence to suggest pregnancy or birth can help endometriosis in the long term.

“There is no absolute cure for endometriosis,” says Dr Teirney. “Pregnancy and breastfeeding does help suppress endometriosis, however it may grow back after you have your baby. But it can be controlled with hormonal medication. In most cases, there’s no reason a woman can’t go on to have a second or third child.”

Thank you to Endometriosis Australia for its generous contribution to this article.

By Carolyn Tate and Sara Mulcahy
Published June 2022

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