Endometrial hyperplasia how to get pregnant. The key to a speedy recovery is. Pregnancy after treatment of hyperplasia

Endometrial hyperplasia and pregnancy are considered incompatible, since infertility is one of the most common complications after the disease in question. Today, this problem is considered one of the most pressing issues of modern medicine. However, competent treatment based on the latest scientific advances still provides women suffering from hyperplasia a chance to experience the joy of motherhood.

What is endometrial hyperplasia?

Hyperplasia is a gynecological disease characterized by excessive growth of endometrial tissue of the uterus. The development of this pathology occurs against the background of hormonal imbalance in the body. Thus, one sex hormone - estrogen - begins to be produced in excess. The production of another hormone, on the contrary, is significantly reduced. As a result of this failure, the process of disorderly growth of the endometrium, which is the mucous uterine layer, begins. Gradually, as it grows, a benign tumor forms, which becomes a serious obstacle to ovulation.

The exact causes of the occurrence and development of pathology have not been established to date. However, experts identify a number of factors that can provoke this disease. These include:

1. Increased level of estrogen in the patient’s body.
2. The presence of chronic inflammatory processes.
3. Metabolic disorder.
4. Diabetes.
5. Abortion.
6. Uterine fibroids.
7. Disturbances in the functioning of the endocrine system.
8. Scraping.
9. Endometriosis.
10. Liver pathologies.
11. Polycystic disease.
12. Tumor formations in the area of ​​the mammary glands and genital organs.
13. Hereditary factor and genetic predisposition.
14. Surgical interventions in the gynecological field.
15. Ovarian dysfunction.

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The effect of hyperplasia on conception and pregnancy

If you are diagnosed with endometrial hyperplasia, conception and successful pregnancy are almost impossible. The fact is that due to hormonal disorders and excessive growth of the endometrium, ovulation does not occur. In addition, the altered structure of the mucous uterine layer is not able to accept the embryo.

But even in that rare case, if conception does occur, the chances of a favorable gestation are practically reduced to zero. During pregnancy, women with this diagnosis experience the following:

1. Incorrect development of the embryo.
2. Congenital pathologies of the fetus.
3. Miscarriage.
4. Termination of pregnancy in the early stages.

In addition, under the influence of changes in hormonal levels associated with pregnancy, the risk of degeneration of a benign tumor in the uterine mucosa into an oncological disease increases significantly. For these reasons, in most cases, for patients suffering from endometrial hyperplasia, doctors strongly recommend artificial termination of pregnancy with subsequent treatment. In order to avoid this, when planning to conceive, you should undergo a medical examination and, if necessary, undergo a course of treatment.

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Signs of pathology

It is quite difficult to determine endometrial hyperplasia on your own, since this pathology does not have pronounced symptoms. In most cases, patients consult a doctor already with the problem of infertility, which is a concomitant complication characteristic of a fairly long course of the disease.

Hyperplasia can be detected in the early stages by regularly visiting a doctor and undergoing routine gynecological examinations.

Experts identify the following signs of pathology:

1. Menstrual irregularities.
2. Heavy and prolonged menstruation.
3. Minor uterine bleeding.

It should be emphasized that identifying endometrial hyperplasia at an early stage greatly simplifies, speeds up the treatment process and allows a woman to maintain the ability to conceive.

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Is pregnancy possible with hyperplasia?

For a long time it was believed that endometrial hyperplasia is a kind of death sentence that deprives a woman of any chance of having a healthy baby. However, medicine does not stand still. Today, there are certain schemes for effective therapy for hyperplasia, and after completing a course of treatment, successful conception and pregnancy become quite real. In order to restore reproductive function, a woman first needs to undergo a thorough examination to identify the form and severity of the disease, after which a specialist determines an individual course of treatment.

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Treatment method

Treatment of hyperplasia begins with a thorough medical examination to determine the form of the pathology in question. For these purposes, a histological examination of the endometrium is performed. In addition, to achieve favorable results, it is necessary to identify and, if possible, eliminate the cause that triggered the development of the disease. At the next stage, depending on the results obtained, the specialist develops a therapeutic course.

Usually the curettage procedure is carried out first. Many women are afraid to do it, believing that curettage can cause subsequent problems with pregnancy. However, experts say that this procedure is absolutely safe, moreover, curettage significantly increases the chances of successful conception.

Oral contraceptives are often used to treat hyperplasia, but if a woman plans to become pregnant in the near future, hormonal therapy is preferred.

Preferably, drugs belonging to the group of gestagens (for example, Duphaston or Utrozhestan) are used to combat the pathology in question. To increase the effectiveness of hormonal therapy, concomitant intake of vitamins B and C, as well as iron supplements, is recommended. It should be emphasized that the selection of the drug, determination of its dosage and duration of administration are carried out exclusively by the doctor, individually in each specific case. This takes into account not only the form of the disease, but also the patient’s age, weight, and the presence or absence of concomitant diseases.

In the early stages of development, endometrial hyperplasia responds quite well to treatment. The therapeutic course takes on average about six months. Pathology in an advanced form with the presence of accompanying complications requires longer and more difficult treatment.

Endometrial hyperplasia and pregnancy are practically incompatible. Even in rare cases, when a patient suffering from this disease becomes pregnant, the chances of carrying and giving birth to a healthy child are minimal. Therefore, it is important to know the signs of pathology and promptly undergo the necessary therapy at the initial stages of pregnancy planning.

Endometrial hyperplasia is a pathological process accompanied by significant growth of the mucous membrane of the uterine layer of the endometrium, developing as a result of hormonal imbalance. As the disease progresses, benign neoplasms form, interfering with conception and ovulatory processes.

The disease can be triggered by factors such as endometriosis, polycystic ovary syndrome, disruptions in the endocrine system, previous curettages, abortions and other gynecological surgical interventions.

With uterine endometrial hyperplasia, patients exhibit the following clinical signs:

• uterine bleeding;
• menstrual disorders;
• excessively heavy, intense, painful menstruation.

The hyperplastic process in the initial stages can be identified through regular preventive gynecological examinations. Doctors say that timely diagnosis and treatment of this disease increases a woman’s chances of becoming pregnant.

Possibility of conception and pregnancy

Is it possible to get pregnant with endometrial hyperplasia? According to gynecologists, the chances of bearing and giving birth to a child, even for those who were able to conceive with this diagnosis, are reduced to zero. This is explained by the fact that the proliferation of the endometrial layer and hormonal disorders interfere with ovulatory processes.

The structural structure of the uterine mucosa changes, which prevents the acceptance and consolidation of the embryo. Such manifestations are most typical for the glandular form of the disease. Therefore, pregnancy and the glandular form of endometrial hyperplasia are incompatible concepts.

Focal endometrial hyperplasia gives a chance to conceive a child, but such a pregnancy is extremely difficult and can be interrupted at any time. In addition, there is a high probability of developing complications and concomitant diseases.

Complications and consequences

Is pregnancy possible with diagnosed endometrial hyperplasia? According to experts, pregnancy with endometrial hyperplasia is almost impossible.

Pregnant patients with endometrial hyperplasia in most cases experience the following complications:

• spontaneous miscarriages in the early stages;
• disruption of the processes of proper embryonic development;
• congenital pathologies of the fetus.

In addition, in patients with hyperplastic pathology during pregnancy and accompanying hormonal changes, the risk of developing the following concomitant diseases increases many times:

• uterine fibroids;
• formation of tumor neoplasms of a malignant nature;
• PCOS;

• polyposis;
• cystic neoplasms localized in the ovarian region.

Due to the high risks of developing cancer, experts recommend that patients undergo artificial termination of pregnancy followed by a therapeutic course. Pregnancy after endometrial hyperplasia is quite possible with adequate, and most importantly, timely therapy.

Treatment methods

In the treatment of this pathology in patients of reproductive age, experts give preference to conservative methods that allow preserving the ability to bear children. If there is uterine bleeding, the first step is to stop it using the therapeutic curettage procedure.

At the next stage, a course of hormonal therapy is carried out, aimed at reducing the levels of estrogen hormones and their effect on the endometrial layer.

The average duration of a therapeutic course is about six months. After this, restorative therapy is carried out for another 6 months, aimed at normalizing hormonal levels, the menstrual cycle, ovulatory processes and reproductive function.

In the absence of proper effectiveness of conservative therapy, with an advanced form of the disease, the need for surgical intervention arises. The operation is performed mainly by hysteroscopic resection, which allows preserving reproductive function.

However, if the pathological process is severely advanced, occurs in a severe, atypical form, and there are concomitant diseases, such as polycystic ovary syndrome, tumor neoplasms, more serious, large-scale surgical interventions may be required. Resection of the uterus or ovary can deprive the patient of her chances of motherhood, which is why it is so important to undergo the necessary therapy in the early stages of the development of the pathological process.

Pregnancy after hyperplasia

So, after completing treatment for endometrial hyperplasia, is it possible to get pregnant? Doctors note that if the therapy was carried out competently and in a timely manner, the patient has every chance of conceiving and successfully giving birth to a healthy baby. If difficulties with conception persist, women who have suffered this pathology are recommended to use the following methods of reproductive medicine:

• artificial insemination IVF;
• intracytoplasmic injection of sperm into the cytoplasm of the egg.

These procedures significantly increase the likelihood of pregnancy, even after severe endometrial hyperplasia.

Planning a pregnancy

Pregnancy after treatment for endometrial hyperplasia requires competent planning and constant monitoring by qualified physicians. The timing of subsequent conception is determined primarily by the method of treatment. If hormonal therapy was used to combat the pathology of the endometrial layer, you can plan the onset of conception literally 4 weeks after stopping hormonal drugs. If the patient has undergone surgical intervention, then before planning a pregnancy a rehabilitation period is required, the duration of which is at least six months.

To prevent endometrial hyperplasia, increase the effectiveness of treatment and increase the chances of pregnancy, patients should adhere to certain rules:

• regularly visit a gynecologist for medical examinations (at least 2 times a year);
• consult a doctor if suspicious vaginal discharge, uterine bleeding, or menstrual irregularities appear;
• prevent weight gain;

• avoid stressful situations and psycho-emotional shocks;
• stop smoking;
• eat properly and rationally;
• be active, mobile, play sports.

When planning a pregnancy after completing a treatment course, you must strictly listen to the recommendations of your doctor. After the end of therapy, a repeated comprehensive diagnosis is carried out to ensure that the problem has been eliminated and there are no risks to the health of the patient and her unborn child.

Endometrial hyperplasia and pregnancy do not go together. Not only does this pathology reduce the chances of successful conception, but even if it does occur, there are high risks of spontaneous abortion, the development of congenital pathologies in the child, and oncological processes in the expectant mother.

Having completed an adequate therapeutic course, a woman may well give birth to a healthy baby.

But gynecologists emphasize that in order to preserve reproductive function, it is very important to identify the disease and carry out the necessary treatment in the early stages of the development of the pathological process before conception.

Hyperplasia of the endometrium of the uterus - This is a pathological growth of the endometrium. The endometrium is the inner (mucous) lining of the uterus. This part of the uterus is subject to cyclic changes during the menstrual cycle.Under the influence of hormones, the endometrium normally grows, changing its structure in anticipation of a fertilized egg, and then, if conception does not occur, it gradually decreases and leaves the uterus along with menstrual flow. After this, a new cycle of changes in the endometrium begins.

Hyperplasia of the endometrium of the uterusthere are several types:

• glandular hyperplasia
• glandular cystic hyperplasia
• atypical endometrial hyperplasia(adenomatosis or adenomatous hyperplasia)
• focal endometrial hyperplasia – polypsendometrium

Endometrial hyperplasiaoften occurs without symptoms and is detected during a routine gynecological examination using ultrasound. Recently, asymptomatic gynecological diseases have become very common, includingincluding sexually transmitted ones.Pathological discharge from the genital tract is not always observed in such diseases.Without the help of laboratory diagnosticsIt is difficult to distinguish them from normal discharge. With the latent course of female diseases, there is no abdominal pain,bleeding disorders of the menstrual cycleand other symptoms. Therefore, every woman needs a preventive examination by a gynecologist at least twice a year.

Signs of uterine endometrial hyperplasia

Endometrial hyperplasiauterine bleeding is often asymptomatic, but sometimes manifests itself as dysfunctional (anovulatory) uterine bleeding.They often occur after a delay in menstruation,less often - against the background of a regular cycle. Often, the diagnosis of endometrial hyperplasia is first made when a woman begins to be examined for infertility.

Lack of pregnancy with endometrial hyperplasia is due to two factors:

• lack of ovulation, due to hormonal imbalances due toendometrial hyperplasia
• impossibility of embryo implantation into the pathologically altered uterine mucosa

In such cases, treatment of infertility by stimulating ovulation, supporting the luteal phase of the cycle, using anti-inflammatory therapy and even IVF will be unsuccessful until the main cause of infertility – endometrial hyperplasia – is identified and eliminated.

Causesendometrial hyperplasia diverse.

First of all, these are hormonal disorders, pathology of carbohydrate, lipid and other types of metabolism, gynecological diseases, surgical interventions on the appendages and uterus. Endometrial hyperplasia is often found in women suffering from hyperestrogenism, uterine fibroids, mastopathy, endometriosis, polycystic ovary syndrome, fat metabolism disorders (the synthesis of estrogens in adipose tissue is impaired), hypertension, high blood sugar, and liver diseases in which hormone metabolism is disrupted.

Diagnosis of endometrial hyperplasia of the uterus

C ate And:

• prevention and treatment of infertility
• prevention of endometrial cancer

Different types of endometrial hyperplasia differ in their histological picture, i.e. microscopic structure of areas of mucosal growth obtained during biopsy:

• glandular and glandular-cystic hyperplasia are almost identical in their manifestations, the second form is more pronounced
• endometrial polyps arefocal, limitedendometrial hyperplasia
• with atypical hyperplasia, there is a structural restructuring of the mucosa, a more pronounced proliferation of endometrial glands, which is considered as a precancerous disease of the endometrium
• Very dangerousglandular endometrial hyperplasiaof any type, reoccurring after curettage and resistant to hormone therapy.

For diagnosticsendometrial hyperplasiause a variety of methods:

1. The most common is pelvic ultrasound. An ultrasound picture of the uterus can often accurately diagnose endometrial polyps, as well as see thickening of the uterine mucosa. Unfortunately, the accuracy of the method does not exceed 60%.
2. Echohysterosalpingography (Echo-HSG) is primarily aimed at studying the patency of the fallopian tubes, but the screen clearly shows the features of the uterine cavity, characteristic of hyperplasia and endometrial polyps.
3. Aspiration or biopsy of the uterine mucosa is performed in the second half of the cycle. The gynecologist (usually under ultrasound control) inserts a special instrument into the uterine cavity and captures a minimal amount of tissue, which is then examined under a microscope. However, the accuracy of the method may suffer due to the fact that the biopsy will be done in the wrong place where there is a focus of hyperplasia.
4. The most informative method for diagnosing endometrial hyperplasia is hysteroscopy - the introduction of an optical system into the uterine cavity, under the control of which a targeted biopsy is performed. In addition, hysteroscopy allows you to visually assess the condition of the uterine walls.

Treatment of endometrial hyperplasia, first of all, consists in removing an area of ​​pathological mucosa. Curettage is performed under hysteroscopy control, and then a histological examination of the mucosa is performed. After removal of the lesion, hormonal therapy is prescribed. Depending on the symptoms, estrogen-progestin drugs (in the form of oral contraceptives), pure gestagens or GnRH agonists are used. Treatment of endometrial hyperplasia is carried out strictly individually for at least three months (rarely - more than six months of continuous use of hormonal drugs). The result of treatment is confirmed by repeating an endometrial biopsy.

Depending on the type of endometrial hyperplasia, the severity of the process, as well as the effectiveness of the therapy, one can judge the prognosis for the upcoming pregnancy!

It is often diagnosed when a woman is being examined for infertility. With such a pathology, it is not only very difficult to get pregnant, but it is absolutely forbidden to do so.

However, don't be upset. Endometrial hyperplasia and pregnancy go well together, but only after a course of treatment. To date, treatment regimens have been developed that allow you to successfully conceive and carry a baby to term.

Endometrial hyperplasia is its excessive growth. The cause may be chronic inflammation, but most often this condition occurs with absolute or relative high levels of estrogen.

These female sex hormones promote the growth of the endometrium in the first phase of the cycle. They are produced in the ovaries by maturing follicles. However, after ovulation, progesterone becomes the main hormone, which protects the endometrium from hyperplasia.

Therefore, this disease occurs with prolonged exposure to estrogen on the uterus, when there is no protective effect of progesterone. This is possible both with inadequate hormonal therapy with estrogen, and with various diseases, for example, obesity, PCOS.

Endometrial hyperplasia is a consequence of prolonged progesterone in the body. In addition, it produces estrogens, especially when there is a lot of it. In the presence of ovarian tumors that produce hormones, their number also increases, causing hyperplasia.

With such conditions, ovulation, as a rule, does not occur. And even if this happens, implantation of the embryo and its development into the altered endometrium becomes almost impossible.

And even if pregnancy occurs, there is a very high probability that it will develop with pathologies. In addition, bearing a baby in the presence of benign formations is contraindicated, as it accelerates the onset of a malignant process. Therefore, endometrial hyperplasia and pregnancy can trigger the development of uterine cancer.

For the prognosis and development of treatment tactics for this disease, its form is very important. It can be determined by obtaining it using scraping. It is better to perform this procedure under hysteroscopy control. This increases the efficiency of the operation.

This manipulation is also the first stage in the treatment regimen. Hormone therapy is then carried out. When choosing drugs, the patient’s age, weight, and concomitant diseases are taken into account.

The goal of treatment is to prevent the development of cancer and infertility. If the patient wishes to become pregnant, prepare her for this.

Pregnancy is also best combined, since it is least likely to lead to cancer and is easier to treat. If complex atypical hyperplasia is diagnosed, treatment will be longer and more complex. After completing the reproductive function, the patient may be offered removal of the endometrium or uterus, especially in case of relapse of the disease.

If, during an examination, a diagnosis of endometrial hyperplasia is made, and IVF or ICSI is planned by a couple in the future, then the disease must first be treated, otherwise attempts will be unsuccessful. After successful therapy, conception occurs.

However, endometrial hyperplasia and pregnancy can only be combined if treatment is successful. But how well the disease responds to treatment depends on its neglect and individual characteristics. Relapses are possible, the need to change the drug, increase the dose. Constant monitoring by a doctor is important.

Thus, endometrial hyperplasia and pregnancy are compatible, but only after successful treatment of the disease. Conceiving with such a diagnosis is not only problematic, but also extremely undesirable, since the likelihood of pregnancy complications and the development of cancer increases.

Endometrial hyperplasia is a disease of the uterus caused by improper production of the hormones progesterone and estrogen in a woman’s body. In this case, progesterone is produced in insufficient quantities, and estrogen, on the contrary, is produced in excess. This leads to changes in the mucous layer of the uterus - the endometrium. New cells form on its surface, which grow and form a benign tumor.

Endometrial hyperplasia - general characteristics and symptoms of the disease

Sometimes hyperplasia may not be expressed in any way and may not bother the woman, but in most cases the disease manifests itself as uterine bleeding, disruptions in the menstrual cycle and infertility.

Endometrial hyperplasia and pregnancy are phenomena that are extremely rarely observed at the same time. As a rule, a woman suffering from hyperplasia suffers from infertility and only after treatment does the long-awaited pregnancy occur.

No matter how unpleasant the symptoms of the disease may be, one cannot help but admit that in some cases they are a kind of benefit for a woman. After all, many ladies put off visiting a gynecologist until the last moment, not knowing how dangerous endometrial hyperplasia is. Meanwhile, modern medicine increasingly views this disease as a precancerous condition. Indeed, in addition to infertility, an increase in the thickness of the endometrium due to hyperplasia can lead to the transition of a benign growth into a malignant tumor.

Types of endometrial hyperplasia and effects on pregnancy

There are several types of endometrial hyperplasia:

• glandular hyperplasia;
• glandular cystic endometrial hyperplasia;
• endometrial polyps – so-called focal hyperplasia;
• atypical hyperplasia.

The most dangerous to a woman’s health is atypical endometrial hyperplasia. It is this type of disease that leads to malignant tumors and, in fact, is a precancerous condition. According to recent observations, the danger of cancer also occurs with focal endometrial hyperplasia, although until recently this form of the disease was not considered as a cause of cancer.

The remaining types of hyperplasia do not pose an immediate threat to life, but are direct causes of a woman’s infertility. With glandular cystic hyperplasia, as with glandular hyperplasia of the endometrium, pregnancy does not occur due to the cessation of egg development, although the thickness of the endometrium in such types of disease does not exceed one and a half to two centimeters.

Pregnancy with endometrial hyperplasia occurs extremely rarely and is observed mainly in the focal form, when the egg develops on an intact area of ​​the uterine mucosa. Focal endometrial hyperplasia and pregnancy are a rare exception to the rule and the only form of hyperplasia, during which a woman can become pregnant. Such cases are rare and require careful and gentle treatment under the supervision of a specialist.

With timely diagnosis and proper treatment, favorable conditions appear for pregnancy after endometrial hyperplasia. Here, the first place is regular examination by a doctor, passing the necessary tests and following all recommendations.

At the slightest suspicion of endometrial hyperplasia, an ultrasound diagnosis is performed. This method allows you to examine the structure of the endometrium, measure its thickness and make an accurate diagnosis. In addition, intrauterine ultrasound is a reliable prevention of hyperplasia if performed at least once every six months.