Endometriosis And Infertility (continuation)
Endometriosis risk factors
Several factors place you at greater risk of developing endometriosis, such as:
• Never giving birth
•Starting your period at an early age
•Going through menopause at an older age
•Short menstrual cycles – for instance, less than 27 days
• Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
•Low body mass index
•Alcohol consumption
•One or more relatives (mother, aunt or sister) with endometriosis
•Any medical condition that prevents the normal passage of menstrual flow out of the body
•Uterine abnormalities
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you’re taking estrogen.
Complications
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant.
Fertilisation and implantation
For pregnancy to occur, an egg must be released from an ovary, travel through the neighboring fallopian tube, become fertilized by a sperm cell and attach itself to the uterine wall to begin development. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg.
Even so, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer
Ovarian cancer does occur at higher than expected rates in women with endometriosis. But the overall lifetime risk of ovarian cancer is low to begin with. Some studies suggest that endometriosis increases that risk, but it’s still relatively low. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. Secondary infertility shares many of the same causes of primary infertility.
Among the possible causes of secondary infertility are:
• Impaired sperm production, function or delivery in men.
• Fallopian tube damage ovulation disorders, endometriosis and uterine conditions in women.
• Complications related to prior pregnancy or surgery.
• Risk factor changes for you or your partner, such as age, weight and use of certain medications.
If you have frequent, unprotected sex but don’t become pregnant – after a year if you’re younger than 35 or after six months if you are 35 or older – talk to your health care provider.
Depending on the circumstances, both you and your partner might need medical evaluations. Your doctor can help determine whether there’s an issue that requires a specialist or treatment at a fertility clinic.
Secondary infertility can be stressful. Do not try to cope alone. Seek support from your partner, family and friends as you talk to your health care provider about the next steps.