Is it possible to get pregnant with internal endometriosis? How is the diagnosis made? Treatment of illness with pregnancy: myth or truth

Female infertility is a pathology caused by various reasons, most often hormonal disorders. One of the consequences of hormone imbalance is the growth of the inner layer of the uterus - a disease called. Why is its appearance dangerous?

Many people wonder “how to get pregnant with endometriosis,” because according to statistics, it ranks 3rd among the causes of infertility. The fact is that it is very difficult to diagnose in the early stages, while there is a chance to get rid of it.

The signs of endometriosis are quite vague and common to all gynecological ailments:

• menstrual irregularities;
• spotting between cycles;
• lengthened periods;
• soreness and discomfort before and during the cycle, which sometimes develop into severe pain;
• unpleasant sensations of fullness, heaviness when standing, pressure in the lower abdomen, in the rectal area, increased urination;
• back pain during menstruation.

Symptoms resemble any of the gynecological pathologies. Therefore, most often, after going to a gynecologist, we return with a different diagnosis, since one examination by a gynecologist is not enough to determine the initial stages of endometriosis - a diagnostic hardware and laboratory examination is necessary.

If you have endometriosis, is it possible to get pregnant? Endometriosis is a disease that is difficult to treat, constantly recurs, and can bring a lot of trouble to the owner. In the early stages, it is not an obstacle to conception, but an advanced disease may well become a cause of infertility. Carrying a woman with endometriosis is fraught with a premature pregnancy or the threat of miscarriage. Therefore, it is corrected with special hormonal therapy.

Endometriosis

A disease under this name is nothing more than a hormonally provoked increase in the inner layer of the uterus, which is normally completely rejected and removed from the cavity along with menstruation.

With endometriosis, rejection occurs unevenly; in place of the remaining cells, a lesion is formed that can grow into the myometrium. Multiple foci cause uterine adenomyosis, the main symptoms of which are:

• violation of the elasticity of the walls;
• increase in size;
• soreness.

The possibility of becoming pregnant with this form of endometriosis is greatly reduced.

Cavity endometriosis is foci of endometrial cells, which, when attached to any organ, are capable of actively multiplying and migrating, provoking the appearance of new foci of the disease. In addition, cysts can grow into the cavity of any organ and tissue, causing serious damage. Endometriosis in the vagina over time becomes an obstacle to conception.

A functional feature of such cells is the fulfillment of their “duties” outside the uterus: they live according to the laws of the cycle, causing inflammatory processes, adhesions, irritation of tissues and nerve endings by rejection of cell layers during the cycle.

Causes of problems with pregnancy

And yet, is pregnancy possible with endometriosis? The appearance of the disease is caused by hormonal imbalances: the balance between estrogen is disturbed, provoking a pathological enlargement of the endometrium. During pregnancy, a fertilized egg is immersed in this loose layer of cells. If fertilization does not occur, the endometrial layer is excreted from the body during menstruation.

However, hormonal imbalance provokes uneven growth of the endometrium, and even partial reflux of cells into the body cavity, with blood flow during the cycle. There, the cells that the weakened body refuses to destroy take root and form cysts and multiple lesions.

Why are endometriosis and pregnancy incompatible? In a uterus with an unevenly grown endometrium and focal cysts, it becomes increasingly difficult for a fertilized egg to implant. The stronger the damage to the organ, the less chance of getting pregnant.

Another reason is the ability of cysts to germinate and bind organs and tissues - this process causes disruption of the patency of the fallopian tubes and the appearance of endometrial ovarian cysts. With endometriosis, you can become pregnant if the patency of the fallopian tubes has not undergone serious changes.

The third cause of infertility may be an imbalance of hormones, which causes disturbances in the cycle, ovulation, maturation of the corpus luteum, and pathological enlargement of the endometrium.

How to diagnose the disease

During a routine examination by a gynecologist, a diagnosis of endometriosis can only be made if the disease has caused damage to the uterus and vagina. A physical examination reveals painful nodular formations, and a significant enlargement of the organ. Doctors do not always give a confident answer to the question of whether it is possible to get pregnant with endometriosis of the uterus. Pregnancy with endometriosis of the uterus is greatly complicated; it is possible only after a course of treatment, and in order to prescribe it, the diagnosis must be confirmed.

The following methods and methods are used for this:

• colposcopy;
• hysteroscopy;
• CT, MRI, ultrasound;
• laboratory tests for tumor markers;
• laparoscopy.

Laparoscopic examination is a unique diagnostic method - it can be used to detect endometrial lesions in the uterine cavity and at the same time take a biopsy sample for laboratory testing.

All other methods diagnose endometriosis quite effectively, but they often have to be used in combination. Diagnosing endometriosis in the early stages is a chance to get rid of the disease once and for all. Therefore, be more careful and persistent when choosing a survey method.

Fight and search

Traditional medicine offers only two options for solving the problem:

• prescribing hormonal drugs - with their help they try to induce a condition similar to menopause. In this way, it is possible to prevent relapses of endometriosis, further contamination of the uterine cavity and body, and cause the reverse development of the glandular epithelium. This method, unfortunately, has very unpleasant consequences for the female body, because the “hormonal storm” greatly affects the hormonal background and health of a woman. In addition, it does not provide any guarantee that after stopping the medication, endometriosis will not begin to recur;
• surgical removal of cysts and foci of contamination using laparoscopic or other methods. Today, this is the only method that is guaranteed to get rid of endometriosis. It is usually prescribed in combination with hormone therapy, physiotherapeutic procedures, and other methods.

The third method can be used to treat uterine and early endometriosis, and herbs can also stimulate ovulation before pregnancy.

After laparoscopy and hormonal therapy, the chances of getting pregnant increase many times: 80% of women who treated the disease in time successfully conceived and carried a pregnancy to term. During gestation, the expectant mother and doctors need to pay double attention, since sometimes the pregnancy is difficult and the threat of failure remains, in which case medicinal support for gestation is provided.

Where can you find useful information?

Illness is not a death sentence. It’s worth checking this out for yourself by finding any forum on the Internet where mothers with this diagnosis, who successfully carried and gave birth to children, share their own experiences. The question is often asked here: “Endometriosis, is it possible to get pregnant with this disease?” - and receive specific answers to it.

The forum for young mothers is an excellent information field where they will help you find out: who became pregnant with endometriosis, whether it is possible to carry a child with endometriosis, what treatment is needed during pregnancy, which folk method to choose in combination with traditional methods to stimulate ovulation.

The forum will help with recipes for the most effective herbs. Try to focus only on positive reviews. It is often recommended at such sites, but only an experienced specialist can diagnose and recommend the selection of funds, based on the results of laparoscopy. By the way, any city forum for young mothers will help you decide on the choice of a good specialist and the place for the procedure.

The forum can become not only your psychological support in difficult times, but also a way to find the necessary recipes, remedies, methods of struggle and prevention, sometimes completely fantastic, but, surprisingly, effective!

Bibliography

1. Arterial hypertension in pregnant women. Is it just gestosis? Guide for doctors. Makarov O.V. 2006 Publisher: Geotar-Media.
2. Ascending infection of the fetoplacental system. Glukhovey B.I. 2006, Publisher: MEDpress-inform.
3. Neonatology: national guidelines. UMO stamp for medical education. Editor: Volodin N.N. 2007 Publisher: Geotar-Media.

Unfortunately, modern medicine states that most often causes of infertility are gynecological diseases, one of which is endometriosis.

Fortunately, the pathology can be diagnosed and successfully treated, which in the future gives hope for a successful pregnancy and the opportunity to become a happy mother.

What is endometriosis and what are its signs?

During the course of the disease, a woman’s body experiences pathological changes, in which the cells of the uterine mucosa - the endometrium - take root in places uncharacteristic for them.

For example, they can be found in the ovaries, inside the uterine wall, fallopian tubes, peritoneum, rectum or bladder. Despite the fact that the cells turned out to be in an unnatural environment for them, this does not prevent them from functioning like the endometrium of the uterine mucosa.

Experts identify endometriosis genital and extragenital. From the gynecological side, it is necessary to consider only genital endometriosis, which is associated with the genital organs of the female body.

Upon examination, endometriosis can be detected by the following: signs:

1. white plaques, red or dark blue spots located on the organs of the reproductive system;
2. ovarian cysts, inside of which there is a liquid resembling chocolate;
3. nodes that have grown into the vagina, bladder, ureters or rectum.

Concomitant signs of pathology are adhesions, which, as a rule, are located in the zone of formation of the disease focus.

What are the reasons for the development of the disease

Most susceptible to disease women of reproductive age. If the menstrual cycle proceeds normally, without failures or pathologies, then during menstruation the blood along with the endometrium enters the abdominal cavity, but is safely excreted from the body. If certain malfunctions are observed, endometrial cells are able to take root outside the uterus.

In gynecology, factors are identified that cannot be called the causes of the development of pathology, but which may be catalyst and increase the risk of disease:

1. Hereditary predisposition. In this situation, certain mutations occur in the body, as a result of which the body is not able to eliminate foci of pathology.
2. Ecological situation.
3. Hormonal imbalances.
4. Decreased immunity.
5. Heavy and prolonged menstruation.
6. Short menstrual cycle.
7. Individual features in the structure of the fallopian tubes.
8. It is possible that the cause of the development of the disease may be (especially) or surgery on the uterus.

Symptoms and stages of the disease

Pain syndrome that is chronic

As a rule, the pain focus is in the lower abdomen. In the first stages of pathology development, pain sensations may be inconsistent and also vary in intensity.

Often the pain becomes more pronounced in the period before and after menstruation, as well as during intimacy. However, over time the pain becomes chronic.

This is due to the fact that the pathology spreads to neighboring organs causing their anatomical changes, provokes the formation of scars and adhesions.

Infertility

Is pregnancy possible with endometriosis? According to statistics, every fourth patient with this diagnosis cannot conceive a baby.

Clinical studies have proven the fact that pathology causes changes in the body that prevent pregnancy. For example, an adhesive process is actively occurring in the pelvic area.

Thus, a natural barrier is formed that prevents conception, since the egg cannot penetrate the uterus. Endometriosis of the cervix or ovary can also cause ectopic pregnancy.

The female body is deprived of the opportunity to perform one of its most important functions - reproductive.

Menstrual irregularities

This symptom manifests itself in the form of heavy bleeding on the days of menstruation, as well as in the form of minor discharge in the period between menstruation. If you do not respond to such a symptom in a timely manner, it is possible

Psycho-emotional disorders

It is quite obvious that a chronic disease, which is accompanied by infertility and a number of other unpleasant factors, is a very difficult test for a woman. As a result, there is depressive state, which often requires the help of a psychologist.

Stages of the disease

The degree of endometriosis depends on how deep the pathology is located.

Undoubtedly, the last stage of the disease is the most difficult to treat, since the affected area is quite large.

How does the treatment work?

With endometriosis, certain pathological processes occur in a woman’s body that prevent the egg from leaving the ovary and also prevent it from moving freely through the fallopian tubes. As a result, infertility develops.

It is quite difficult to diagnose pathology during an examination by a gynecologist; in this situation, they are used additional methods:

1. Colposcopy - examination of the cervix is ​​carried out with a special microscope.
2. Ultrasonography.
3. The most effective diagnostic method is. During the manipulations, the specialist can visually assess all foci of pathology, as well as take a biological sample for the necessary histological examination. Typically, the abdominal and pelvic cavity is examined. The procedure uses a video camera, which is inserted into the abdominal cavity or through a puncture in the vagina.

Treatment consists of surgically removing all foci of pathology in the body, including ovarian cysts and nodes in the retrouterine space. All these manipulations are carried out during.

Under general anesthesia, a specialist makes three punctures in the abdominal cavity. Then, through these punctures, dangerous foci of pathology are removed.

Considering that the entire operation is carried out without traditional trauma to the body, the postoperative period is easy, without pronounced discomfort. On average, the patient is under constant supervision of a specialist no more than two days.

Unfortunately, there are options when minor foci of endometriosis remain in the body. This happens if the pathology spreads on the bladder or rectum. Removing lesions can damage organ tissue.

Then hormonal therapy is necessary, which is the final stage in treatment. You will need to take hormonal medications for six months.

Treatment results - what to expect?

The probability of pregnancy after endometriosis laparoscopy is quite high, the percentage of successful conception ranges from 40 to 70. However, it should be borne in mind that the effect after the operation is rather short-term nature, so experts advise trying to conceive a baby as soon as possible. The longer the period passes after laparoscopy, the more difficult the situation with pregnancy will be.

If within a year after all procedures, this may be due to other factors. In this situation, alternative methods of reproduction, such as in vitro fertilization, will be required.

According to statistics, after successful treatment under the guidance of an experienced specialist, most women can still become pregnant and give birth to healthy babies.

Endometriosis remains one of the most common and most misunderstood diseases in gynecological practice. The disease can occur with minimal symptoms or bring unbearable pain and other problems to the woman, including interfering with conception and the normal course of pregnancy. What can be done to prevent endometriosis and pregnancy from opposing each other?

The extent to which endometriosis can affect the process of conception and pregnancy largely depends on the stage and extent of the disease. Many women have minor symptoms of the disease with localization of lesions in the ovaries or cervix, and their pregnancy proceeds without complications. In others, endometriosis is detected only during a thorough examination, when infertility has already been established.

Features of the disease

There is no single theory of the occurrence of the disease. Some scientists even believe that endometriosis is not a separate pathology of the genital organs, but a systemic disorder. Others compare the disease to cancer - in severe forms, the disease brings no less problems, and the only thing that distinguishes it from a malignant neoplasm is that endometriosis is not fatal.

The incidence of endometriosis is steadily increasing. This may be due to improved diagnostics and equipment. Approximately a third of women with established pathology have problems with conception and pregnancy. The following facts regarding endometriosis are reliably known.

• There is no radical treatment. The lack of a reliable theory of the occurrence of the disease entails the impossibility of constructing an effective treatment plan. All the methods and methods that are used can only temporarily relieve the manifestations of the disease. Very quickly, lesions appear in other places, even if endometriosis was treated surgically.
• The lesions contain endometrial cells. Endometriosis of any localization, when performed by ultrasound, has tissue identical to that in the uterine cavity. Endometrial cells undergo the same cyclic changes. But unlike the uterine cavity, where there is a connection with the vagina and this makes it possible to remove its contents every month, other structures and organs of the small pelvis do not have such conditions. Therefore, a semblance of menstrual blood accumulates or is released into the abdominal cavity. This leads to the formation of cysts (on the ovaries) with thick, dark brown and sometimes even black contents. In addition, “bloody” lesions irritate the tissues every month, causing the formation of adhesions, pain and local inflammation.
• There is a hereditary predisposition. It has been noted that the likelihood of developing the disease is several times higher in women whose grandmothers and mothers suffered from a similar illness.
• The disease is hormonally dependent. One feature of endometriosis is reliably known - the manifestations of the disease increase with an imbalance of sex hormones and sharply decrease with an excess of gestagens - hormones of the second phase of the menstrual cycle. The latter happens during pregnancy, so endometriosis often recedes for a while after childbirth. Also, with the onset of menopause, when the level of sex hormones is minimal, the disease goes away and only some of its consequences remain. All this is used to treat and attenuate the disease, including when planning pregnancy.
• Surgeries increase the risk of endometriosis. Any surgical intervention, especially on the genitals, increases the risk of developing endometriosis. This applies to cesarean section, removal of myomatous nodes with surgical penetration into the uterine cavity. Endometriosis of the cervix often forms after cauterization.

Who's at risk

Endometriosis can occur at any time throughout life. The following women are at risk:

• if childbirth was accompanied by massive ruptures;
• if manual examination or curettage was performed during childbirth;
• if a caesarean section was performed;
• if close relatives have endometriosis;
• with numerous abortions;
• with chronic inflammatory processes in the pelvis;
• in conditions of chronic stressful situations.

How to understand that there is a pathology

The clinical picture of endometriosis is nonspecific, but based on the combination of symptoms, it is highly likely that the correct diagnosis can be assumed.

• Chronic pelvic pain. This is one of the constant signs of endometriosis. Painful periods and discomfort in the lower abdomen bother you on the eve of your period and after it. Pain occurs during sexual intercourse, and sometimes intimate relationships become almost impossible. The intensity of pain varies from slight nagging to unbearable.
• Daub. Spotting is a sign of cervical endometriosis or adenomyosis (damage to the muscular part of the uterine body). The duration and intensity of spotting depends on the severity of endometriosis. As a rule, spotting occurs two to three or more days before menstruation and continues for a week or more after it.
• Violation of the cyclicity of menstruation. Spotting may become more abundant, making it difficult to determine the start and end time of menstruation. Also, with endometriosis, women often experience hormonal imbalances, which lead to irregular periods.
• Heavy menstruation. When the body of the uterus is damaged (adenomyosis), the volume of blood loss during menstrual periods increases. This is one of the obvious manifestations of adenomyosis along with spotting.
• Infertility. Endometriosis of the uterus, cervix, fallopian tubes, endometrioid ovarian cysts, as well as complications of the disease often lead to infertility.
• Psychological problems. Constant pain, discomfort, restrictions in intimate relationships are imprinted on the psycho-emotional state of a woman. It has been noticed that the pain threshold may decrease - even minor pains are perceived as very intense. As a result, women with endometriosis are more irritable, hot-tempered, unsure of themselves, and hysterical.
• Signs of damage to other organs. Endometrioid lesions can appear on absolutely any internal organs and even on the skin (especially in the area of ​​postoperative scars). If the bladder is damaged, blood appears in the urine during menstruation, and the rectum - traces of blood in the stool. Often there are lesions on intestinal loops, peritoneum (covers the abdominal cavity from the inside), cases of endometriosis being detected on the liver, brain and eyeball are described.

Stages and degrees of the disease

Depending on the location, genital endometriosis is distinguished (when the genital organs are affected) and extragenital (when lesions occur on other organs). According to ICD-10, endometriosis is coded N80. Based on the damage to the intra-abdominal organs, the following stages of endometriosis are distinguished.

• Stage 1. Small lesions are found in the peritoneum adjacent to the uterine appendages.
• Stage 2. Damage to the appendages and fallopian tubes with the occurrence of adhesions. Formation of small foci on the parietal peritoneum.
• Stage 3. Spread of lesions to the space behind the uterus (rectovaginal) and in front (vesicovaginal) with the involvement of other organs (bladder, ureters, urethra, rectum, small intestine, including the appendicular process).
• Stage 4. It is characterized by the appearance of multiple foci of endometriosis on all structures and organs of the pelvis. There are numerous adhesions and deformations of organs (for example, ureters).

As the stage of the disease increases, the clinical picture worsens. With the first, the woman’s quality of life does not suffer, with the fourth, in addition to infertility, issues arise in intimate relationships and ability to work, for example, due to pain during menstrual periods.

If only the body of the uterus is affected, endometriosis can also have significant consequences for the woman, but the lesions on the internal organs and peritoneum will be minimal. In this case, there is a separate classification.

• 1st degree. It is characterized by damage to the uterine wall at the level of the submucosal layer.
• 2nd degree. The myometrium is affected no more than half.
• 3rd degree. Endometrioid “passages” reach the outer (serous) lining of the uterus.
• 4th degree. It is characterized by the spread of the process to all layers of the uterus, peritoneum and nearby organs.

How to identify

Endometriosis is diagnosed before pregnancy. During gestation, all symptoms of pathology are significantly reduced due to an increase in the amount of gestagens during this period. Endometriosis can be suspected based on a woman’s complaints and a general gynecological examination. But the diagnosis can be definitively confirmed only with the help of certain manipulations.

• Ultrasound of the pelvis. Echo signs of endometriosis are not always visible with ultrasound. Most often, an assumption about the disease can be made with endometrioid cysts and adenomyosis.
• Hysteroscopy. This is an instrumental research method in which a special device (hysteroscope) is placed through the cervical canal into the uterine cavity. This allows not only to examine the endometrium through eyepieces (or the image is displayed on the monitor screen), but also to cauterize areas of hyperplasia, remove polyps and small fibroids in the submucosal layer, which can be detected along with endometriosis and cause infertility. Hysteroscopy helps detect lesions on the cervix and cervical canal, as well as in the myometrium (adenomyosis). It is necessary to carry out hysteroscopy on the eve of menstruation, then areas of endometriosis look like “honeycombs” with bleeding “snakes”.
• Laparoscopy. This is the “gold standard” not only in diagnosis, but also in the treatment of endometriosis. In addition, pregnancy planning for overt endometriosis should always include diagnostic laparoscopy. It, like any operation, requires certain preparation (diet the day before, sanitation of the genital tract with suppositories) and prevention of complications after execution (antibiotics). Laparoscopy is an operation during which manipulators are installed through several punctures, with their help you can view the structures of internal organs and carry out high-tech interventions. During laparoscopy, myomatous nodes and ovarian cysts can be removed. But the main thing is that during the manipulation, a several times enlarged image is displayed on the monitor screen, so even the smallest foci of endometriosis in the peritoneum can be identified and removed using cauterization or tissue excision.
• Abdominal surgery. Sometimes the diagnosis of endometriosis is made during routine surgery, for example to repair a ruptured endometrioid cyst.
• Hysterosalpingography. Helps determine the patency of the fallopian tubes in endometriosis.
• Colposcopy. This is an examination of the cervix, which, using magnifying technology, allows us to identify foci of endometriosis in it.
• Other methods. Less often, there is a need to perform an MRI or CT scan of the pelvic organs to determine the extent of the process.

Endometriosis and pregnancy: how the disease interferes with conception

The question often arises whether it is possible to get pregnant with endometriosis, and whether the concepts of adenomyosis and pregnancy are compatible. Approximately two out of three women with infertility have some form of endometriosis, but the disease is not always the reason for the inability to become a mother. The main problems that can lead to infertility with endometriosis are as follows.

• Hormonal disorders. Endometriosis can occur due to hormonal changes or cause them independently. Because of this, the ovulation process is disrupted and pregnancy pathology occurs.
• Ovarian exhaustion. Detection of endometrioid cysts (often they are bilateral) is an indication for their removal. During surgery, it is often necessary to excise most of the ovarian tissue. Even at a young age, this can lead to premature exhaustion of the ovaries and a decrease in their reserve. At the same time, the likelihood of spontaneous pregnancy decreases sharply.
• Obstruction of the fallopian tubes. Almost always, endometriosis is accompanied by adhesions in the pelvis. Lesions on the fallopian tubes and adhesions lead to obstruction and the appearance of a mechanical barrier on the path of the sperm to the egg. If the tubes are not completely blocked, the risk of ectopic pregnancy increases, even after treatment for endometriosis. Laparoscopy helps to partially overcome the adhesive process and increase the chances of conception.
• Miscarriage. Even if conception is successful and the fertilized egg enters the uterine cavity, the process of implantation - its introduction into the endometrium - is not always successful. Adenomyosis during early pregnancy can lead to detachment and arrest of chorion development. In this case, hysteroscopy will help reduce the manifestations of internal endometriosis in the uterine cavity and increase the chances of a successful pregnancy, during which pathological areas can be specifically removed and cauterized.

Treatment to help you become a mother

Many women have heard that treatment of adenomyosis, endometriosis of the cervix and other localizations can be carried out during pregnancy. In reality, during pregnancy, serious hormonal changes occur in a woman’s body. The predominance of gestagens leads to regression of endometriosis foci, but not to its complete disappearance. This also happens during breastfeeding, so women are advised to continue lactation as long as possible.

ECO

With adenomyosis and endometriosis, women often lose hope of detecting the first signs of pregnancy. At the same time, it is difficult not only to conceive, but also to bear it. Therefore, we often have to resort to ECO technologies. When several of the following factors are combined in the setting of endometriosis, assisted reproductive technologies should be used:

• woman's age after 40 years;
• problems with reproductive function in men (insufficient sperm count, poor motility);
• the presence of several miscarriages or missed pregnancies;
• infertility for more than two to three years during treatment;
• obstruction of the fallopian tubes or their absence.

But even IVF guarantees a successful pregnancy only in 50-60% of cases. Therefore, couples should not waste precious time on unsuccessful treatment of endometriosis for many years - a woman’s reproductive age is short.

When turning to assistive technologies after 35 years, it is useful to carry out cryopreservation of eggs, which will increase the chances of conceiving in the future. Reviews from women and doctors confirm the fact that babies born from frozen eggs do not differ in level of health and development from ordinary children.

Is it possible to conceive naturally?

If endometriosis is the cause of infertility in a woman, she should undergo comprehensive treatment to increase the likelihood of conception and pregnancy. It includes the following points.

• Advanced laparoscopy and hysteroscopy. Laparoscopy is performed to determine the extent of endometriosis and eliminate obstacles to conception. At the same time, hysteroscopy and hysterosalpingography are performed to determine the patency of the fallopian tubes. Thus, during one operation, it is possible to remove lesions on the peritoneum and pelvic organs, remove endometrioid cysts (if any), examine the uterine cavity for polyps, hyperplasia, and remove as much as possible foci of endometriosis inside the uterus. The duration of such an operation varies from an hour to two or three, it is performed under general anesthesia. But the result after such an intervention is worth it.
• Long-term hormonal treatment. To consolidate the effect and increase the chances of a successful pregnancy for three to six months, the girl is prescribed hormonal treatment. The choice of drugs and regimen depend on the age and severity of the disease. Conventional contraceptives are used (for example, “Janine”, “Yarina”, “Jess”), gonadotropin agonists and antagonists (Buserelin injections), progestin drugs (good effect after tablets “Duphaston”, “Visanne”, “Mirena”).
• Additional treatment. In combination with the main therapy, vitamins (especially A, E, C), homeopathy, and folk remedies (various herbs, infusions, bee products, suppositories with mumiyo) can be used. In some cases, hirudotherapy - treatment with leeches - helps, however, contraindications to the procedure must be taken into account. Proper nutrition and normalization of body weight are useful. But you shouldn’t expect that the lesions will resolve - as an independent treatment, all these methods are ineffective, the result is noticeable only in combination with the main therapy and surgical interventions.

How does gestation proceed?

The symptoms of pregnancy in adenomyosis and in healthy women are no different - signs of toxicosis appear, basal temperature rises, and according to tests, the level of human chorionic gonadotropin increases. If conception occurs independently or after treatment due to endometriosis, the risk of complications increases most in the first trimester. This is due to the fact that during this period the fertilized egg moves through the fallopian tubes, then it penetrates the uterine wall.

After the second trimester, in most cases, pregnancy proceeds without deviations. However, diffuse adenomyosis and endometriosis of other parts increase the risks of missed abortion and spontaneous miscarriages, as well as ectopic pregnancy.

Endometriosis is a serious disease, the causes of which remain unknown to this day. The pathology brings many inconveniences and problems to a woman, including the possibility of infertility. Treatment of endometriosis during pregnancy is carried out by the body itself - a certain hormonal background helps to reduce the symptoms and size of the lesions. But often, conception requires serious surgical interventions, long-term hormonal therapy, and the entire preparation process can drag on for several years.

Print

Women often face diseases of the reproductive organs that interfere with conceiving and bearing a child. Within this article, we will talk about endometriosis and pregnancy - how they affect each other and whether their symbiosis is possible in the body of one woman. Let's start with the disease.

About endometriosis

Endometriosis is a complex disease in which cells that cover the internal cavity of the uterus during the menstrual cycle (forming a bed for a fertilized egg) spread to the abdominal organs. In the process of monthly changes in the body, endometrial cells (as they are called) grow and are removed from the body of the uterus during menstrual bleeding (if pregnancy does not occur). These cells are not removed from other organs and with each cycle they grow more and more, put pressure on neighboring organs, affect their functioning and provoke.

The causes of the pathology have not been thoroughly studied. The following factors are believed to play a major role:

1. Hormones. It is under the influence of hormones and hormone-like substances that the endometrium grows; their source can be organs of the endocrine system or formations (tumor-like or cystic) in the abdominal cavity.
2. Immunity. If the immune system is working at full strength, then endometrial cells are not able to attach to organs or tissues; they are able to grow only in the body of the uterus. When the system fails, endometriosis occurs.
3. Heredity. The presence of endometriosis in close relatives (mother, sister, grandmother) increases the likelihood of the occurrence of pathology.
4. External interventions. Frequent abortions, operations (caesarean section, including), instrumental examinations, installation of an intrauterine device - everything can become a prerequisite for the development of endometriosis.
5. Diseases. Often the cause of the pathology is chronic inflammation of the pelvic organs, including the reproductive organs.
6. Unbalanced supply of essential substances from food. In particular, iron deficiency.

Read more about the causes, diagnosis and treatment of endometriosis.

Probability of pregnancy

Endometriosis can affect your ability to conceive. There are many reasons for this and they are connected not only with the consequences of the disease, but also with the factors that caused the pathology.

1. Hormones. Disturbances in the ratio of hormones affect the menstrual cycle, the functioning of the corpus luteum, and the formation of antibodies to the male seminal fluid in the abdominal cavity (lead to the destruction of the sperm structure). Serious changes can exclude ovulation in principle and lead to. Also
2. Inflammatory diseases. Inflammation directly interferes with the normal functioning of the uterus and appendages, which makes it impossible for a fertilized egg to grow into the surface of the mucosa.
3. Spikes. Endometriosis provokes inflammation in the fallopian tubes; during healing, inelastic scars are formed, which lead to. The same obstacle may be an overgrown endometrial lesion.
4. Changes in the endometrium of the uterus, in which the egg cannot attach to its surface.

Is it possible to get pregnant with endometriosis?

Yes, this is possible, only 40% of patients are diagnosed with infertility, in the remaining 60% fertility is preserved. With the help of modern medications and manipulations, the chance of having a child for most women is significantly increased, but a successful outcome depends on a combination of factors and concomitant diseases.

Therapy methods

How to get pregnant with endometriosis? This question worries all young women who are faced with the problem. The doctor will determine the individual tactics of action in each case. First of all, it is necessary to find out the cause of the pathology and influence it, preventing further development of the disease. The following methods are used for treatment:

• Hormone therapy

Thanks to synthetic hormones, hormonal balance is restored, and endometrial growth outside the uterus stops. Duphaston is often prescribed for a course of several months - it is an analogue of progesterone, and it is its deficiency that is noted in patients with endometriosis.

• Surgery

During the manipulation process, the doctor removes all areas of the overgrown endometrium mechanically. Currently, minimal intervention techniques are used. The operation is performed using micro-instruments, which are inserted into the abdominal cavity through several punctures. During laparoscopy, it is also possible to remove adhesions and restore patency of the fallopian tubes. In the postoperative period, hormone therapy is necessary to minimize the risk of relapse.

• Waiting method

It is used if a woman is not planning a pregnancy, and the symptoms of the disease do not cause discomfort. Such patients need to regularly monitor the condition of their internal organs and be examined for the presence of tumor markers in the blood to prevent endometriosis from turning into cancer.

Treatment of the disease is not absolute, relapses are possible, so it is necessary to be constantly monitored by a doctor. Pregnancy after endometriosis can occur with complications, but timely hormonal correction will reduce the likelihood of miscarriage to a minimum.

Risks during pregnancy

If a woman has no idea about the disease and pregnancy with endometriosis of the uterus occurs naturally, this is not a reason to relax. Carrying a child can have complications:

• The risk increases. It is necessary to carry out an ultrasound examination and removal of the fertilized egg if necessary in the early stages.
• Due to changes in the uterine lining, the risk of spontaneous miscarriage increases, especially during the first trimester.
• Hormonal imbalances can lead to increased tone of the uterus and contractions of its muscles, causing miscarriage, so synthetic hormones are prescribed.
• The walls of the uterus can become thinner, so as the fetus grows, the likelihood of their rupture increases. Patients with this diagnosis are sent to the hospital long before birth, for the purpose of observation and, if necessary, an emergency caesarean section.
• Adhesions on the cervix lead to loss of its elasticity. Impaired distension may affect its dilatation, so the doctor will choose delivery by cesarean section.

Modern techniques allow the birth of a healthy baby. The period of waiting for the baby, of course, will be a little darkened, but the result will be worth it.

If you cannot get pregnant after treatment

If there is no pregnancy, the doctor will suggest a procedure that takes place in several stages:

1. Stimulation of egg maturation.
2. Egg retrieval.
3. Artificial insemination with the husband's seminal fluid and growing the embryo in a special environment.
4. Preparing the female body for replantation.
5. Replanting.
6. Maintenance hormonal therapy.
7. Evaluation of the result.

Prognosis of the course of endometriosis after pregnancy

During pregnancy, complex hormonal changes occur. Often, bearing a child and subsequent breastfeeding help get rid of the pathology. This is explained by the prolonged absence of the menstrual cycle and changes in hormones that promote endometrial growth. For a young mother, it can be a pleasant surprise that there are no difficulties with subsequent pregnancies.

Of course, a relapse of the disease is possible after breastfeeding ends, but you should always hope for the best.

Among the most common diseases, gynecologists call uterine endometriosis, which is one of the causes of female infertility. To date, the reasons for its occurrence have not been fully elucidated, but, according to statistics, this pathology is often detected during a routine examination. Women periodically complain of recognizable symptoms - 15% to 40% of patients of childbearing age. They are often interested in whether it is possible to get pregnant with endometriosis. Although doctors do not give a definite answer, with a detailed consideration of the topic, each person will have an understanding of this issue for herself.

Endometriosis: what is it and how does it manifest?

Any gynecological disease threatens the ability to get pregnant, carry and give birth to a full-fledged baby. Women are aware of this, so they try to be treated for any diagnosis, even without fully understanding its meaning:

• inflammation of the appendages;
• endometriosis;
• myoma;
• ovarian cyst;
• hormonal imbalance, etc.

Taking care of the reproductive function of the body is not only your own problem, but also a guarantee of an established personal life with happy motherhood. Many young girls are terrified of getting pregnant before marriage, without thinking about infertility. After many years, they begin to wonder about the chances of getting pregnant with endometriosis.

Some ladies are in no hurry to treat a pathology that prevents normal fertilization, using it as a natural “contraceptive” remedy. The disease enters a chronic phase, after which it is much more difficult to fight. It happens that pathological tissues, growing, cover nearby tissues located in the abdominal cavity near the uterus, ovaries and appendages.

The other extreme is to attach a tragic connotation to any diagnosis. Having learned about the pathology and inflammatory process, first of all they want to know whether this will affect the possibility of getting pregnant and giving birth to a baby in the future. On women's forums there are often topics like “is it possible to get pregnant with chronic endometriosis?” or “girls, share who unexpectedly became pregnant with endometriosis.”

Much less often people are interested in the causes of the disease and its symptoms. But they are individual for everyone, for example, abnormalities in the immune system or hormonal levels. Often added to this is the hereditary factor, poor environment and unhealthy diet - beer and crackers, which are abused by young people.

In medical practice, cases of such diseases have been recorded in young girls who have not had sexual experience, and mature women after the cessation of menstruation. Most often, endometriosis occurs in women of reproductive age - from 30 to 45 years. Only after effective treatment can a doctor answer the question - is it possible to get pregnant after treatment for endometriosis?

How is endometriosis formed and what does it affect?

With endometriosis, there is a pathological growth of the mucous membrane and tissue located in the inner layer of the uterus. But such fouling can envelop other organs, forming adhesive processes and complicating their full functioning.

Often pathological tissues form entire clusters on the surface of the uterus, ovaries and nearby organs:

• fibrous and cystic;
• polyps;
• benign and malignant formations.

Abnormal cells can also grow in the passages or inside the uterus, or form in the intestines and lungs. Rejection of such tissue can be seen on menstruation days, when the uterus “bleeds”. The mucous layer can exceed the norm several times, so the fertilized egg enters the overgrown mucosa, but it can develop normally. Therefore, it is sometimes possible to become pregnant with endometriosis and carry a child to term.

Not all women complain about their pathologies to doctors, even during a routine examination, especially when deviations from the norm are not accompanied by pain. Some people are terrified of surgical operations and hardware cleaning, so they are in no hurry to solve infertility problems with the help of traditional medicine. At the same time, at every opportunity they try to find out whether it is possible to get pregnant with a diagnosis of endometriosis.

Most often, painful sensations and protracted periods are considered to be “normal” and the pain sensations are “treated”, and not the disease itself. With uterine pathology, many women try to survive to menopause and move on with their lives, in the hope that it will “go away on its own.” They are more concerned about spotting (between menstruation and after sexual intercourse), as well as irregular cyclicity, than about their own health and why endometriosis prevents them from getting pregnant.

Mucosal nodes grow in the reproductive organs - this is genital endometriosis, but there is also an extragenital or external process. Foci of the disease are also detected in the abdominal organs and postoperative scars. All this negatively affects the female reproductive organs, affecting the uterus. Depending on the location, doctors distinguish the following types:

• retrocervical;
• peritoneal;
• extraperitoneal endometriosis.

If the disease is not treated, endometrial or mucous cells grow abnormally outside the uterus. This results in the formation of cystic or focal neoplasms, which are influenced by hormonal levels. Often the surgical decision is a struggle with the consequences, without searching for the reasons for the diagnosis. The disease manifests itself in different ways, most often the disease makes itself felt:

• lower abdominal pain;
• acute pain during menstruation;
• deviations in cycle frequency;
• hemorrhages after sex, which interferes with normal marital life;
• pain when urinating or defecating;
• bloody issues;
• infertility (in the absence of obvious pathologies);
• a large amount of bloody discharge during menopause.

It is characteristic that most gynecological pathologies are hormone dependent. Excess hormones lead to organic changes and a decrease in the activity of sperm capable of conception.

Why you can’t get pregnant with endometriosis, what’s stopping you

When there are gynecological pathologies, many are interested in the consequences, as well as why they cannot get pregnant due to endometriosis.

1. Hormonal imbalance with a predominance of estrogen suppresses the process of normal ovulation - this is anovulation.
2. The problem is not only this, an increased concentration of female hormones can suppress the activity of the “live animals”, reducing the likelihood of fertilization. This is another reason why you cannot get pregnant after endometriosis.
3. There is also an obstacle to the passage of the egg into the uterine cavity through the tubes due to adhesions. Such deviations from the norm are the cause of ectopic pregnancy. This cannot be said to be directly related to endometriosis, but they are like trees from a common root.
4. In medical practice, there are also frequent cases of extensive damage to the uterine cavity due to endometriosis. Because of this, the fertilized egg does not have the opportunity to develop further without full implantation in the uterine wall. The development of the fertilized egg below (in the cervical region of the uterus) leads to miscarriage.

The essence of the question is not why it is not possible to get pregnant with endometriosis, but why it is not possible to carry the embryo to term. Pathological pregnancy is dangerous for the life of the failed mother due to the likelihood of ectopic pregnancy and fetal death, which is not immediately noticeable.

How to treat endometriosis to get pregnant

It is already clear what happens in the abdominal cavity during gynecological pathologies; now it is worth clarifying how to treat uterine endometriosis in order to get pregnant.

You should not be left alone with the problem if there is no child in the family; it is recommended to receive effective treatment. Hormonal levels need to be adjusted. But nature can take its toll, and endometriosis reoccurs, even during pregnancy.

Most often prescribed:

• drug correction (Duphaston and other medications);
• laparoscopy;
• anti-inflammatory therapy if an infectious process develops in the abdominal cavity;
• concomitant treatment with herbal tinctures according to folk recipes and homeopathic remedies;
• Pregnancy is possible after treatment of endometriosis with Visanne.

Sometimes temporary hormonal “freezing” of the reproductive function of the ovaries is indicated. In this case, it is impossible to get pregnant, but the process of development of endometriosis is stopped.

It is often difficult to get rid of the growth of mucous membrane inside the uterus, but pregnancy has a positive effect on the condition of these tissues. Some women on forums indicate that they managed to become pregnant unplanned after discovering endometriosis in the peritoneum. At the same time, there were no problems with the “travel” of the fertilized egg through the fallopian tubes. There have also been many cases where a child was fully conceived, carried to term and given birth after effective treatment and hormonal correction.

Purposeful women succeed in everything, even giving birth to a baby with pathologies. So you shouldn’t look for an answer to the question “how to treat endometriosis in order to get pregnant,” it’s better to ask your doctor!