Endometriosis and fertility

March is Endometriosis Awareness Month when the spotlight is put on this debilitating condition which affects around 1.5 million women and girls in the UK*. We ask our fertility consultant, Mr Ehab Kelada, if it is possible to conceive a baby with this condition.

What is endometriosis?

Endometriosis is a condition where the lining of the womb grows in other places such as the ovaries, Fallopian tubes, bowel and bladder. When that lining breaks down, like the regular lining in the uterus every month, it has nowhere to go. This can cause inflammation, pain and the formation of scar tissue.

Can endometriosis affect my fertility?

Endometriosis is found in about 10%* of all women of child-bearing age. However, it is present in 25-30%* of women who have a problem conceiving. When the condition is severe, it can cause scar tissue which blocks the Fallopian tubes. However, the presence of endometriosis can compromise fertility even when the tubes are not blocked, but the exact reason for this is still unclear.

Can I still get pregnant if I have endometriosis?

Yes, you can get pregnant both naturally and through fertility treatment, if needed, if you have endometriosis. Nevertheless, women who have endometriosis may have difficulty falling pregnant.

Is there any medication I can take which will improve my chances of conceiving despite endometriosis?

Medical treatment for endometriosis cannot be given for women who are trying to conceive. And, if they are ovulating already, there is no evidence that medications given for ovulation induction will improve their chances of achieving pregnancy.

Can I have fertility treatment with endometriosis?

Yes, however, the stage of your endometriosis will help your doctor come up with a treatment plan. For example, a woman with stage 2 endometriosis may want to try to conceive on her own for a while. A woman with stage 3 endometriosis may be recommended fertility treatment. Usually, IVF would be the best option of treatment to achieve pregnancy in women who have endometriosis. But there needs to be a comprehensive assessment of the couple before discussing the options available to make an informed decision.

Will surgery to treat endometriosis improve my fertility?

Yes, there is evidence to suggest that surgical treatment of endometriosis can improve the chance of achieving pregnancy both naturally and after fertility treatment. Surgical treatment involves destroying the endometriosis tissue using keyhole surgery.

However, surgical treatment of endometriosis is offered primarily for pelvic pain or if there is a cyst on the ovary, secondary to the endometriosis (known as a chocolate cyst).

The decision to do keyhole surgery for treatment of endometriosis to improve fertility levels will depend on multiple factors such as the age of the female partner, the level of her ovarian reserve (ability to produce egg cells), the length of time the couple have been trying to conceive, sperm factor, and the overall assessment of the couple. Fertility treatment may be recommended as an alternative option.

Advice from Mr Ehab Kelada, Fertility Consultant at Spire Gatwick Park Hospital. If you wish to book a consultation with Mr Kelada, please call on 01293 778 906 to find out more.

*Source: Endometriosis UK