It’s been clear for some time that endometriosis may affect your ability to become pregnant. Recent studies also note a higher incidence of miscarriage and ectopic pregnancy among women with this often painful and perplexing condition. Thankfully, rapid advances in medical technology have provided many effective treatment options for endometriosis.
Darin Swainston, MD, FACOG, is a well-known and nationally respected OB/GYN specialist who uses minimally invasive, robotic-assisted surgery to help you successfully manage the symptoms and fertility concerns associated with endometriosis. He’s used his medical expertise and training to serve patients in the Las Vegas area for more than 20 years. Here, he shares his insight about endometriosis and how it may affect your future pregnancies.
The tissue lining your uterus is called the endometrium. This is the area that swells and fills with blood and other nutrients that a fertilized embryo needs to grow and develop. If you don’t become pregnant, the unused tissue and blood is shed during your menstrual period.
Endometriosis occurs when endometrial tissue implants itself outside of the uterus. This displaced tissue most often grows on the outer surface of your uterus, ovaries, and fallopian tubes. It can also develop on the vagina, cervix, and other organs within your pelvic region but very rarely occurs in other parts of the body.
The implanted tissue associated with endometriosis continues to respond to the hormonal changes you experience during your menstrual cycle. It goes through a period of growth and then sheds unused blood and nutrients into the surrounding tissues. This activity often causes the same cramping pain you experience during your period.
Over time, endometriosis can cause the formation of scar tissue in your pelvic region. This creates additional pain and can eventually block structures needed for reproduction, such as your fallopian tubes. It’s estimated that 11% or more of American women between the ages of 15 and 44 have endometriosis.
You may not even realize you have endometriosis. Some women experience very few symptoms and have no problems with fertility or moving through a healthy pregnancy.
Many women, however, experience significant problems with endometriosis. Pain is the most commonly reported symptom; women often describe it as extremely painful menstrual cramps that worsen over time. Endometriosis can also cause pain during or after sexual intercourse, long-term (chronic) back and pelvic pain, and spotting or bleeding between your periods.
You may also note abdominal bloating and problems with constipation or painful bowel movements. About half of the women who have endometriosis also have fertility issues.
An extensive study presented at the European Society of Human Reproduction and Embryology in 2015 noted that women with endometriosis are at a greater risk of experiencing miscarriage or an ectopic pregnancy.
The study indicated that of the 5,375 pregnant women with endometriosis who participated in the study, compared to 8,280 pregnant women without endometriosis, the risk of miscarriage was 76% higher and the risk of ectopic pregnancy was three times greater in women with endometriosis.
It’s believed that the inflammation and structural changes associated with endometriosis may affect your ability to carry a pregnancy to full term. For instance, endometriosis can alter the shape of your uterus and make it difficult for an embryo to develop normally. Scar tissue (adhesions) can block the natural course of a fertilized egg and result in an ectopic pregnancy.
Many women with endometriosis who are not interested in becoming pregnant often respond well to treatment with hormonal birth control medication that regulates your natural estrogen production.
If you’re interested in becoming pregnant or do not respond well to medical therapy for endometriosis, I often recommend surgery to remove misplaced endometrial tissue and adhesions that have developed in the pelvic region.
The robotic-assisted techniques I use for this type of surgery enhance the precision necessary to remove the endometrial tissue from your fallopian tubes, ovaries, or other involved areas without damaging delicate reproductive structures in the process.
The minimally invasive nature of the surgery, which requires just a few small incisions, also leads to quicker recovery times and lower risks of bleeding and other complications during the procedure.
Many women with endometriosis can carry a pregnancy to full term and deliver a healthy baby. If you’re pregnant and have a diagnosis of endometriosis, however, I do recommend very careful monitoring throughout your pregnancy. This may include additional ultrasounds, lab studies, and doctor visits to ensure your pregnancy is proceeding without complications.
While there’s no real cure for endometriosis, advances in medical technology and improved surgical techniques have greatly increased the odds of successfully managing your symptoms and helping you experience a healthy pregnancy.