Many women with endometriosis are able to conceive, and help is on-hand for those navigating endometriosis and fertility.
One of the most pressing concerns on the minds of women* diagnosed with endometriosis is how the condition might affect their chances of conceiving.
As well as being associated with chronic, and sometimes debilitating pelvic pain, endometriosis is also linked to an increased difficulty in conceiving. Many women only discover they have endometriosis when seeking fertility treatments.
How does endometriosis affect fertility?
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. But recent figures show that the outlook for women with endometriosis who want to become pregnant might be brighter than previously thought.
Described as "the first ever blueprint seeking to improve the treatment, understanding and awareness of an often misunderstood and crippling condition", Australia’s National Action Plan for Endometriosis finds that up to one in three women with endometriosis will face fertility challenges as a result of the disease.
This means two-thirds of women living with the condition can count endometriosis out as an obstacle to the success rate of conception.
Donna Ciccia, director and cofounder of Endometriosis Australia says, “while some women with endometriosis may have trouble conceiving, many will go on to have a baby, despite complications resulting from the disease.”
“When I was 25 my specialist sat me down and said it would still be possible for me to have children, but that endometriosis meant there were implications for my fertility, and that I should be mindful of those,” says now 29-year-old mum, Ann-Maree.
“It was relieving and daunting at the same time, because I was so not ready to have the family conversation — I was still a baby myself.”
Endometriosis treatments to improve fertility
Endometriosis is a common condition and treatments that may improve fertility include laparoscopic surgery (removing endometrial tissue causing blockages), fertility medication coupled with medical insertion of sperm directly into the uterus, and IVF.
It’s important that women and couples look at all the factors influencing their fertility and discuss these with a doctor. Just because a woman with symptoms of endometriosis is struggling to become pregnant, it doesn’t necessarily follow that the disorder is the cause of her fertility challenges. Other common causes of subfertility include medical conditions, irregular or absent periods, and low sperm count.
Donna warns women and couples against comparing their experiences with others – what worked for a friend with endo, may not be right for you, she says.
"You need to be guided by your doctor so they can tailor an approach specifically for you. If you’re undiagnosed and you have been trying for a while to get pregnant, then start with your GP. Have that conversation and go from there."
Mixed messages: endometriosis and pregnancy
Many Aussie women believe that having a baby is one of the reliable treatments, or even possible cures, for their endometriosis, says women’s health Postdoctoral Research Fellow, Mike Armour.
Armour says this advice comes from “a wide range of sources: from self-help books to web forums to medical professionals”, but he stresses there’s no evidence to suggest pregnancy or birth can cure endometriosis.
For those living with endometriosis who do conceive, experiences of pregnancy can be mixed. For some, pregnancy is a symptom-free time, while others experience the same or worse symptoms than they battled before.
While some common treatments for endometriosis – such as contraceptive pills and devices – aren’t suitable during pregnancy, Donna says there are other options that might be explored for pain relief during this time. Talk to your doctor or obstetrician about your treatment options and what might work best for you.
Endometriosis and the journey to parenthood
Donna says that while it can be difficult for the approximate 30% of women with endometriosis who face fertility challenges, Endometriosis Australia and other support organisations such as 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.
Thank you to Endometriosis Australia for its generous contribution to this article.
*HCF acknowledges individuals in the transgender community and people who are non-binary and living with endometriosis who may not identify as women.
WHAT IS ENDOMETRIOSIS?
Endometriosis is one of the most common gynaecological causes of chronic pelvic pain, affecting one in nine Australian women by age 44.
While there is no cure for endometriosis, there are options to help improve quality of life.
Hope for women with endometriosis
New research initiatives and public awareness are giving hope to Aussie women living with the condition.
Endometriosis comes laden with its fair share of old wives’ tales. We cut through to the latest thinking.