Endometriosis

What is Endometriosis?

Endometriosis is a medical condition in which endometrial-like cells grow outside of the uterine cavity in areas where they should not normally appear. The most common location for endometriosis is on the ovaries. These endometrial-like cells are influenced by changes in hormones just as the uterine wall's endometrial cells are, and symptoms often become worse during the menstrual cycle.  
Many of these women are considered subfertile or infertile, particularly when there is scarring in the tissue growth (endometrium). Technically infertility is a symptom, not a cause of endometriosis.

Medical experts do not yet know what exactly causes this condition and why it decreases female fertility. Decreased fertility may be a result of endometrium scarring in the pelvis that could affect the Fallopian tubes, which transport the eggs from the ovaries. Endometriosis also produces hormones and substances that may adversely affect a woman’s reproductive process.

There is a generalization that women with endometriosis often have difficulty becoming pregnant because of their condition. This might be because women who have difficulty conceiving are more likely to search for a diagnosis than those who do not. Many women have endometriosis and do not become aware of it until they are trying to conceive a child.

Studies have shown that women who suffer from minimal to mild endometriosis might require more time to conceive a child and might be less likely overall to conceive, compared to women who do not suffer from endometriosis. Endometriosis does not mean, however, that a woman is infertile or will have great difficulty conceiving. Typically, women who are experiencing infertility consult their gynecologist in search of answers, and this is when the signs of endometriosis are discovered. The connection between endometriosis and infertility, then, is not always understood. Additionally, women who have moderate to severe endometriosis might experience greater difficulty in conceiving than women who have minimal to mild endometriosis.


What are the symptoms of endometriosis ?


Pain in the lower abdomen or the pelvis is the most common symptom of endometriosis, often during or just before your period and lessening after menstruation. A woman afflicted with endometriosis may also feel pain outside her monthly period. Pain may also be felt during ovulation, when passing urine, during or after sexual intercourse, in the lower back region, in the lower back, in the legs

Other symptoms:
  • diarrhea and/or constipation (in connection with menstruation)
  • heavy/ irregular menstruation
  • abdominal bloating (during menstruation)
  • chronic/ recurring pelvic pain
  • high blood pressure
  • coughing up blood
  • rectal bleeding
  • blood in the urine or the stool
  • frequent or urgent urination
  • difficult or prolonged menstruation
  • severe ovulation cramps
  • irregular bowel movements
  • dysmenorrhea (menstrual cramps)
  • nausea and vomiting (in severe cases)
  • previous miscarriage/s or ectopic pregnancy

What are the treatments for endometriosis associated with infertility?

There is no current cure for endometriosis, but some procedures can treat the condition and make conception possible (depending on the condition’s extent):

Surgery

If your endometriosis is moderate to severe and you want to conceive, undergoing a laparoscopic surgery might work for you. Laparoscopy is also one of the most effective methods in treating endometriosis as long as all the endometriosis tissues have been removed.

Laparoscopy improves fertility by 40 to 60 percent for women scarred by endometriosis tissue and by 10 to 90 percent for those with cleared Fallopian tubes.

Medication

Medicines can significantly or completely treat mild endometriosis in most women. Prescribed drugs such as birth control pills can suppress the condition and relieve endometriosis-related pain.
Endometriosis-specific drugs such as GnRH agonists (Lupron, Synarel, or Zoladex) and testosterone derivatives have been designed to regulate estrogen production and postpone ovulation for a short time.

Artificial insemination

IVF

Natural Treatments to treat endometriosis, such as adopting healthier eating habits (lessening/ eliminating caffeine, sugar, and alcohol and consuming organic food) and supplementing essential nutrients such as Vitamin B complex may help lower your estrogen level.

You can also do exercise, yoga, and meditation to improve your general and reproductive health.

Hello Doctor,

I am Mrs Devina from Maryland. I am 35 years old and I have been trying to get pregnant since 7 years now. 5 years ago I was diagnosed for having Endometriosis. Since then I was on medication, with no positive results. In May 2012, I underwent a Laparoscopy and it was found that both tubes were blocked due to endometriosis and the doctor has suggested an IVF. I wanted to come to India for this. I have surf on the net and found about your clinic. Interested to come there. Would you please be able to guide me how much it would cost in indian rupees (treatment and my stay) and for how many days I'll have to be in India to plan my holidays ? And also what would be my success rate? Would be really grateful to you.

Thank you,

Regards,

Devina


Hello Doctor,

I am Kaberi from Kolkata. I am 35 years old and I have been trying to get pregnant since 4 years now. 2 years ago I was diagnosed for having Endometriosis. Since then I was on medication, with no positive results. Two years ago, I underwent a Laparoscopy and it was found that both tubes were blocked due to endometriosis and the doctor has suggested an IVF. I wanted to come to Delhi for this. I have surf on the net and found about your clinic. Interested to come there.

Thank you
Regards,
Kaberi Bandhopadhyay

Dear Kaberi,

Sorry to learn that you are difficulty in conceiving due to Endometriosis and blocked Fallopian tubes.You are welcome to come to New Delhi, India to get IVF treatment done.

Success depends on you age (quality of eggs) and quality of sperms. Your age is ok. Please send detail about your husbands semen analysis report.

Feel free to contact me for any further queries.

Best regards,
Dr Richa Katiyar


Dear Dr.Richa,

My husband and I have been married for 4 years and have not been able to conceive. I’m 34 years of age and the most recent ultrasound report has shown extensive endometriosis with both blocked fallopian tubes. There are 6 follicles in each ovary and my husband’s semen analysis is normal.

The uterus is retroverted and both ovaries are not mobile. The endometriosis has involved the bowel. Would it be better to undergo laparoscopy for endometrial lesions first or IVF ?

Would much appreciate your opinion as I’m willing to come to you for treatment .

Warm Regards,
Alicia

Dear Alicia,

Sorry to learn that you are having difficulty in conceiving.

If there is extensive Endometriosis involving the bowel, then surgery is not only going to be difficult, it can also be incomplete and risky for you. I will therefore sugest IVF to be the better option, using the ultra long protocol in which we give you a single dose of GnRH agonist in the month prior to the month we plan to do IVF to shrink the Endometriosis in your body.

However I do want to know if there are any Endometriomas of a size more than 3 cms in your ovaries? These are known to have a negative impact on the success of IVF.

Feel free to contact me for further queries.

Best regards,
Dr Richa Katiyar


Dear Mam

Good Evening!!

I got ur email address from internet. Myself Natalya, presently staying in Uzbekistan

Age-38
married since 2009

I was diagnosed with endometriosis in 2008v through laparoscopy and two cyst were removed from both right and left ovary. At present past two months I was put on infertility injections from day 2 and there was no success. Doctor did here HSG test on 16th march 2014 and said report is not satisfactory ( left tube is having adhesions and right tube is swelled up) She suggested now next cycle will "hit n trial"/ will take calculative risk for IUI.

I was in a doubt as in whole cycle she was saying my eggs are maturing through injections and bursting was an issue as it doesn't burst/shrink completely.
Now the second issue as per doctor here is Fallopian tubes, also as per the test conducted here in Dubai my AMH level is 1.07.

Would request if you can go through my hsg report and can advise what is the best possible option in my case.

Looking forward to hearing from you.

Warm regards
Natalya

Dear Natalya,

Sorry to learn that you are having problem in having a baby.

I have gone through all your reports and feel that IVF with the ultralong protocol to suppress the Endometriosis is the best option for you. This should be done after at least a month of giving you medicines to make the AMH levels and the ovarian reserve better.

Feel free to contact me for further queries.

Best regards,
Dr Richa Katiyar
IVF and Infertility Specialist
www.how-to-get-pregnant.in