Endometriosis is a chronic, painful condition that affects women all around the world. It can cause more than just pain, it can lead to inflammation and permanent scarring inside the body. More than that, it can lead to infertility or difficult conceiving for the 30-50% of women who live with it.
How endometriosis affects fertility
Endometriosis interferes with fertility in a number of of ways. Because of the way that endometriosis lesions cause scarring and adhesions, they can cause restrictions in and around important tissues, fascia, and organs like the fallopian tubes or other reproductive structures that your body needs in order to get pregnant. Additionally, the chronic inflammation caused by endometriosis can lead to damage to the sperm and other important components of fertility.
Because endometrial tissue is only supposed to be inside the uterus, the immune system may respond to the endometrial cells with in increased immune response, causing increased tissue inflammation, scar tissue and tissue restriction. This increased immune response that endometriosis causes can also play a role in infertility, as the immune system can damage the sperm, eggs, or embryo. On top of all this, endometriosis can also cause, and be caused by,hormonal imbalances that can also reduce fertility.
Getting pregnant with endometriosis
Though it isn’t without major challenges, it is possible to get pregnant with endometriosis. The odds of conceiving with endometriosis depend on how severe it is, where the endometrial tissue is inside your body, the overall health of your reproductive system, your age, and your overall health. There are many different ways to improve your fertility if you have endometriosis and we will discuss those next!
Treatment options for women with endometriosis trying to conceive
Treatment of endometriosis-related infertility includes many different approaches. Some of these include:
- Pelvic Physical Therapy: All of these changes that endometriosis can cause are things that a pelvic physical therapist, can help you treat. Stretching, relaxing, releasing, and realigning all of the muscles and tissues that are out of whack from endometriosis is something that they specialize in.
- Visceral Manipulation: Addressing the soft tissue, fascial and organ related restrictions through manual therapy and Visceral manipulation can make a huge difference for those living with endometriosis.
- Lifestyle changes: maintaining a healthy body weight, eating a nutrient-rich anti-inflammatory diet and reducing your stress levels are key. Studies have shown that reducing meat and fat consumption, increasing fiber, and eating a plant-based diet might be helpful.
- Stress Reduction: increased stress affects your nervous system, your gut, and your immune system, each of which can be a piece of your endometrial puzzle. This is why a holistic treatment approach is integral.
- Nervous System Regulation: Living in a dysregulated autonomic nervous system state such as fight-or-flight or freeze negatively affects how our organs function, our hormonal system and our gut, all of which can exacerbate and make endometriosis worse.
- Medications: your doctor might recommend or prescribe medications like hormones, birth control pills, or other medications that modulate your hormones for a while to help control your disease before you start trying to conceive. These medications are not used when actively trying to conceive.
- Surgery: Surgery is sometimes used to remove or destroy endometriosis lesions and adhesions to help your reproductive system work properly.
- Assisted reproductive technologies (ART): For some women, none of the treatments above work and they opt to use ART like in vitro fertilization (IVF).
Endometriosis fertility
Though endometriosis can pose a huge challenge when it comes to getting pregnant, the right combination of treatments can help many women conceive. Getting treated as early as possible with the help of an OB/Gyn and reproductive endocrinologist are critical to maximizing your chances of getting pregnant.