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Dealing with endometriosis and pregnancy

A painful condition associated with menstruation, endometriosis is often erroneously equated with infertility. Many women with the condition are led to believe that it is not possible for them to bear children, which is far from the truth. However, to understand how this myth is propagated, let us first know a bit more about the condition.

What is endometriosis?

The uterus is lined with a tissue called endometrium. A part of this tissue is shed during the menstruation cycles. When this layer grows in another place in the body, the condition is called endometriosis. The common places where this layer grows outside of the uterus includes the lining of the fallopian tubes, ovaries, bladder and other areas around the pelvis.

It causes severe pain during normal bodily functions like menstrual periods, sexual intercourse, urination and bowel movement. It can even lead to chronic pain caused due to internal inflammation in the pelvic region. The pain is often so severe that it affects the functionality of the person, interfering with their routine life and reducing their quality of life.

According to the World Health Organisation (WHO), around 10% of women and girls across the world live with this condition. There are several measures of managing it such as use of birth control pills, pain medication, and surgical intervention.

How does endometriosis affect fertility?

Sexual intercourse can be a very painful experience for those with endometriosis. This results in a reduction in their frequency of engaging sexually with their partner, which becomes a barrier to natural conception. Besides, as the basic management protocol for the condition is to reduce ovulation (with the help of hormonal medications like birth control), it reduces the likelihood for a person on these medicines to get pregnant.

Those who have very severe symptoms might opt to take the surgical route to manage it. This means removing the endometrium from the wrong places through surgical intervention. However, this is known to have an adverse impact on the quality and quantity of eggs and thus contributes to the failure of conception, especially among those with very severe symptoms. The last resort for managing the condition is removal of the uterus.

Overcoming endometriosis induced infertility

Pain management

In mild or moderate cases, pain management can usually help in natural conception. When someone with endometriosis is trying to conceive a child, they are asked to stop taking the oral contraceptive medicines if they were having them earlier. Instead, they are prescribed certain safe analgesics and anti-inflammatory drugs. If pregnancy does not occur after six to nine months of trying, gynaecologists may suggest other methods of conception.


Surgery can be beneficial for those with mild or moderate symptoms. It involves removing the endometrium growing in the wrong places by means of a laparoscopic (inserting a camera in the body) surgery which is minimally invasive. The more invasive type of surgery (laparotomy) is considered in very rare cases and can be performed only by very skilled surgeons. There are chances of recurrence of the condition a few years after the surgery.

Assisted reproductive technology

For those who can’t or don’t want to undergo a surgery, doctors usually recommend taking the help of assisted reproductive technology like intrauterine insemination (IUI) and in vitro fertilisation (IVF). These can also be prescribed to couples who fail to conceive even after several months of trying after the surgery.

IUI is also called artificial insemination. It basically involves selecting healthy sperms and directing them into the womb of the mother through asexual means. This is especially useful in cases where something is blocking or misdirecting the sperms when they enter the female’s body.  IVF, on the other hand, is fertilising the embryo outside the uterus and then planting it in the womb of the mother or a surrogate. This technique is especially useful for those suffering from moderate to severe form of endometriosis.

There is hope

To conclude, endometriosis does not eliminate one’s childbearing ability. However, the right course of action depends on several factors including the severity of the condition, the age of the expectant mother, the amount of time already spent in trying for natural conception. You can understand your options from your doctor, weigh the pros and cons with them and then move ahead with the best suited solution.

For women in the reproductive age group, one of the most common endocrine disorders is polycystic ovarian syndrome (PCOS). While the numbers say anywhere between 5 to 12% of women in a community suffer from it, the actual prevalence can be as high as 26%.

Most of the outcomes of PCOS – irregular periods, acne, excessive hair growth and weight gain – can be a little more than minor inconveniences. However, the one effect that has a deeper impact on all aspects of life of a person is infertility. It is well known that women with the condition take much longer to conceive a child, and many of them struggle with the issue for years.

The good thing is that like all other symptoms of the disorder, infertility can also be managed with a combination of lifestyle changes and medication. It is not impossible for women with PCOS to overcome the problem and become pregnant. Read on to know a few simple lifestyle tips that can help you manage PCOS.

Watch your weight

For most women, PCOS causes extreme weight gain. Changing this is often the first step towards increasing one’s chances of getting pregnant. Hormonal imbalance can make this difficult. Getting your BMI (body mass index) checked in order to understand how much excess weight there is to lose and your muscle-fat ratio is a good start. Once the goalpost is ready, you can work towards improving the quality of your diet while also increasing the amount of physical exercise you get. According to the American Association of Clinical Endocrinologists, a weight loss between 5 and 15% vastly improves the condition of anyone with hormonal imbalances.

Focus on ovulation

Irregular or no ovulation that is caused by the hormonal imbalance is usually the direct cause of difficulty in conception, especially for women with PCOS. Ovulation cycles can be tracked with the help of apps or simply by keeping a record of the periods. There are ovulation testing kits to help ascertain that a woman is ovulating. This helps determine the window when the chances of pregnancy are high. Regular ovulation is not enough, though. The eggs released also need to be considerably healthy to get fertilised. Doctors could prescribe medicines or injections for this.

Keep blood sugar in check

PCOS often messes with hormones other than the reproductive ones, especially insulin. This also makes a woman with the condition more likely to develop diabetes or insulin resistance. This imbalance is closely associated with the obesity often accompanying the syndrome. In fact, lowering insulin resistance is one of the primary ways of managing the condition. This can be done with the help of medicines, though some of them would be contraindications for a woman looking to get pregnant. A diet consisting of a lot of fiber and healthy fats may help keep the insulin levels in check as well. Monitoring the blood sugar levels more closely during the time you are trying to get pregnant is advisable.

Don’t sweat it

A stressed out individual has higher chances of producing a lot of hormones associated with reducing the chances of pregnancy. Therefore, it is all the more important to focus on one’s mental health while trying to conceive a child. A lot of the exercise you may be undertaking in order to lose weight, though, would help release happy hormones. You could also decrease stress through yoga and meditation. Additionally, you could indulge in activities that help you relax and destress on a more regular basis.

Keep in mind that a pregnancy in a woman having PCOS is high risk. It increases the chances of miscarriage, gestational diabetes, pregnancy induced blood pressure and several other issues. However, don’t get discouraged by the side effects. Like for conception, you can work with your fertility expert to work on ensuring that you enjoy a healthy and happy pregnancy. And there is overwhelming evidence women with PCOS giving birth to perfectly healthy, full-term babies. Some of them do need to take help of assisted reproductive technologies like in-vitro fertilisation.

When you hold your precious bundle of joy after all this hard work, you can relish the realisation that it was all worth it!

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More articles on Pregnancy & Maternity Tips:

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  2. Pre-natal exercises to reduce stress and lower back pain
  3. The hope and scope of cord blood banking
  4. Second trimester of pregnancy: do’s and don’ts

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