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Diagnosing Endometriosis | Risks to Fertility and Pregnancy | WeNatal

Diagnosing Endometriosis | Risks to Fertility and Pregnancy | WeNatal
Endometriosis is a challenging and often painful chronic gynecological condition affecting millions of women worldwide. It is estimated that approximately 10% of women of reproductive age suffer from endometriosis, with the most common symptom being chronic pelvic pain. Beyond the physical discomfort, endometriosis can significantly impact a woman's fertility, leading to emotional distress and uncertainty about family planning.

In this blog post, we will explore the intersection of endometriosis and fertility, discussing the symptoms, diagnosis, mental health toll, and the importance of a multi-modal approach to care. 


Moreover, we will guide you on when to seek out a fertility specialist and what you can expect on your endo fertility journey.

Understanding and diagnosing endometriosis:

Endometriosis is a condition where tissue similar to the lining of the uterus, called endometrial tissue, grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes, pelvic lining, and even organs like the bladder, lungs and intestines. During each menstrual cycle, these endometrial tissue deposits respond to hormonal changes, leading to inflammation, pain, and the formation of scar tissue.

Symptoms of endometriosis:

The symptoms of endometriosis can vary widely, and some women may experience more severe symptoms than others. Common signs of endometriosis include:


Chronic pelvic pain: This is the most prevalent symptom. The pain can range from mild to debilitating and is often worse during menstruation.


Painful periods: Dysmenorrhea, or painful periods, is a hallmark of endometriosis. The pain can be so severe that it interferes with daily activities.


Pain during intercourse: Painful intercourse, known as dyspareunia, can also be a symptom of endometriosis.


Heavy menstrual bleeding: Some women with endometriosis may experience abnormally heavy or prolonged menstrual bleeding.


Digestive issues: Endometriosis affecting the bowels can cause digestive symptoms such as diarrhea, constipation, or bloating, especially during menstruation.


Infertility: Endometriosis can lead to fertility challenges due to the distortion and scarring of reproductive organs. It’s not until someone struggles with infertility that they discover that they have it. In fact, up to 50% of all infertility cases are known to be from endometriosis. 


Take this quiz if you have not been diagnosed and you want to see if your symptoms could be endometriosis.

Getting an endometriosis diagnosis:

Despite the prevalence of endometriosis, most people go an average of 10 years before they’re able to get an official diagnosis. 


Part of the reason this happens is that diagnosing endometriosis can be complicated, as the severity of symptoms does not always correlate with the extent of the condition. A definitive diagnosis can only be made through laparoscopic surgery, during which a surgeon examines the pelvic organs and removes any endometrial tissue found outside the uterus. 

Approximately 30-50% of women with endometriosis may experience fertility issues, highlighting the importance of increasing awareness earlier in life.

Endometriosis and the impact on fertility

One of the primary concerns for women with endometriosis is how it impacts fertility. Before we get into the ways in which to improve your fertility with endo, let’s review some of the ways in which doctors and scientists believe fertility is impacted by this chronic gynecological condition. 


  1. Decreased egg quality 

Egg quality is a critical factor when trying to conceive because it directly impacts the chances of a successful pregnancy. 


Research has shown that people with endometriosis are more likely to have higher levels of circulating oxidative stressors which may contribute to the damage of the egg cells that reside within the ovaries.


  1. Issues with successful implantation 

Implantation is a crucial step in pregnancy when a fertilized embryo attaches to the lining of the uterus (endometrium) and begins to establish a connection with the maternal blood supply. 


The inflammatory processes associated with endometriosis can disrupt this delicate process via changes to the uterine environment, the formation of adhesions and scar tissue in the pelvic cavity, dysregulation of the immune response leading to rejection of the embryo, hormonal imbalances, and endometrial scarring. 


  1. Possible decreased ovarian reserve

The “ovarian reserve” refers to the number and quality of eggs remaining in a woman’s ovaries.


In particular, if you have endometriomas (cysts that form when endometrial tissue grows and becomes trapped within the ovaries, resulting in a fluid-filled sac), it can affect fertility because it can disrupt normal ovarian function and reduce the number of healthy eggs available for ovulation. 


Whilst egg quantity is an important factor when it comes to available fertile years, it does not necessarily predict how easy or difficult it may be to conceive, so focusing on lifestyle modifications that can help improve your egg quality and maintain your ovarian reserve will be a great idea either way. 


  1. Adhesions/scarring of fallopian tubes and ovaries

Endometriosis can cause adhesions on or in the ovaries and the fallopian tubes. This can make it difficult for eggs to be released effectively from the ovary, and to travel down the fallopian tube for fertilization and then toward the uterus for implantation.


Large adhesions on the ovaries can also reduce blood supply to the area, and trap blood in the ovaries leading to cysts and damage. 


  1. Comorbidity with other uterine structural abnormalities

People with endometriosis are more likely to also have endometrial polyps, which are non-cancerous growths of endometrial tissue in the inner wall of the uterus, as well as fibroids which are also non-cancerous growths made up of dense connective tissue that grows within the muscle wall.  This risk is slightly increased for stage 2 – 4 endometriosis. 


Each factor can be mitigated or improved with the help of medical, or nutritional intervention, which is why working on endometriosis symptom management prior to conceiving can really be the best investment you can make for your current and future fertility health.

Can you get pregnant if you have endometriosis?


Figure out what your goals and timeline may look like

There are a few factors that will influence what your options are when trying to conceive. They are:

  • Whether or not you’ve been officially diagnosed
  • The stage of your endometriosis
  • What interventions you’ve already tried (e.g. surgery, IUI, IVF, etc.)


If you have been officially diagnosed with endometriosis, you can take this quiz to see if endo could be a factor in your fertility.

Get the help you need to make the fertility process easier

It can be a daunting process to figure out if and when to see a specialist, how to advocate for your needs, and what role you can play at each stage in order to optimize your chances of success. There is often a lot of time wasted jumping around to different doctors and taking different tests that may or may not be helpful in getting to your ultimate goal of pregnancy. 


And, because age is such an important factor in fertility, the longer it takes you to get the right care, the bigger impact it will have on your ability to get pregnant in the future. 


But you can now get the care navigation and support you need throughout the fertility journey using online platforms like ELANZA Wellness. They’ve just launched the EverythingEndo app, which includes a dedicated Care Navigator, unbiased education, virtual classes, prescribing clinicians, and a directory of trusted endo specialists. 


They know how deeply personal and complex the fertility journey can be with endo, which is why they’ve put all the tools and support you need in one place, streamlined into a simple, easy-to-use platform. 


It’s also worth noting how much having someone in your corner who knows endo and empathizes with the nuance of the condition can help you manage your stress and breathe a sigh of relief knowing that you’re not alone in the process. 


Helpful resources for trying to become pregnant with endometriosis

Some of the things that can improve the fertility journey with endo:

  • Compassionate care provided by a dedicated Care Navigator specializing in endo
  • A personalized fertility plan, including when to see a fertility specialist
  • Support around insurance reimbursement
  • Stats and strategies around surgery and/or assisted reproduction
  • Mental health resources
  • Pain management classes and education
  • Tools to advocate for yourself throughout the process


Key takeaways about endometriosis and fertility

Endometriosis and fertility present a complex and challenging journey for millions of women worldwide. The statistics indicate that approximately 30-50% of women with endometriosis may experience fertility issues, highlighting the importance of increasing awareness earlier in life. 


While it is still possible to get pregnant without assistance, understanding your options and being proactive about your approach to family-building could save a lot of time, money, and heartache down the road.  


Navigating the intersection of endometriosis and fertility can feel overwhelming, but the good news is that there are new, novel approaches that address each person as an individual, allowing a more personalized and streamlined experience along the road to conception. 


Get a discount on holistic fertility care for endometriosis

WeNatal is excited to partner with ELANZA Wellness, allowing you to receive $20 off your first month on the EverythingEndo platform. Simply use the code WENATAL20 at checkout in order to redeem this limited time offer. 


Better fertility care is possible. 

Company Info & Offer:

EverythingEndo by ELANZA Wellness is a virtual endometriosis support center offering a roadmap to long-term relief from pain and other symptoms and faster access to effective interventions. Membership includes a personalized symptom management plan, prescriptions, specialist support and unlimited access to a range of therapeutic virtual classes, all from the palm of your hand. 


To celebrate this exciting launch, WeNatal (members/subscribers/community?) can now receive $20 off the first month of any subscription plan on the EverythingEndo platform. Simply use the code WENATAL20 at checkout in order to redeem this limited time offer.

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Brittany Hawkins & Catherine Hendy

Dedicated to women's reproductive health, Brittany Hawkins and Catherine Hendy founded ELANZA Wellness to create a lasting impact on those affected by endometriosis. Witnessing the unspoken pain of countless individuals suffering from this chronic condition, they are driven to deliver compassionate and holistic care that has the power to completely transform people’s lives.

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