Endometriosis and pregnancy - planning features (how to prepare). Is it possible to get pregnant with endometriosis and how to increase the chances of successful gestation Are healthy children born with endometriosis

Abnormal growth of endometrioid tissue is a common female disease, often leading to infertility. With its development, pathological foci are formed in the area of ​​the uterus, appendages and other organs of the genitourinary system. Due to this, getting pregnant with endometriosis is problematic. The reproductive system cannot fully function, the menstrual cycle is confused, and often ovulation is not observed at all. There is still a chance of pregnancy at an early stage of the disease.

Many women are convinced that pregnancy with endometriosis is impossible. In fact this is not true.

The disease often leads to the formation of adhesions that interfere with the passage of the fetal egg through the pipes. In addition, the process of maturation of the egg is disrupted. Due to this, the likelihood of becoming pregnant with endometriosis of the uterus becomes significantly less.

Another reason for the difficulties with fertilization is that with the pathological growth of endometrial cells (the mucous layer of the uterus), there is not enough space for the ovum to be fixed. Nevertheless, at the initial stage of the development of pathology, when endometrioid foci are just being formed, it is quite possible to become pregnant.

Operational

Surgical treatment of endometriosis is the most effective method of therapy. The operation to remove pathological areas is most often performed by laparoscopy. The intervention is performed using a special device - a laparoscope equipped with a video camera. Thanks to this, the doctor receives accurate information about what is happening in the internal organs, and can visually control the progress of the procedure.

Relapses after surgery are rare. Accordingly, if it has been cured and does not develop again, pregnancy can occur as soon as possible.

If the disease is in an advanced form, the extent of the lesion is large enough and there is a risk of cell malignancy, they resort to the complete removal of the reproductive organ and appendages. In this case, infertility is diagnosed with endometriosis.

Folk

To make pregnancy after endometriosis possible, they often resort to. It will not be possible to cope with the pathology itself in this way. You can only eliminate the symptoms and reduce pain during the menstrual period.

In the process of planning pregnancy, folk remedies are quite effective. In this case, the root of the white cinquefoil, the upland uterus, St. John's wort and nettle are used. On their basis, decoctions are prepared, which are taken orally.

Pregnancy planning

To give birth to a healthy child, you first need to cure a disease that prevents conception. Pregnancy after endometriosis is not only possible, but desirable. Due to this, the risk of relapse is significantly reduced.

Sometimes the help of a reproductive specialist is needed, so we advise you to read about the procedure.

Prevention

Although it is possible to get pregnant with endometriosis, there is a risk of miscarriage, premature delivery and a number of other complications during the entire period of gestation. Therefore, it is so important to prevent the development of the disease and prevent its reappearance after the end of therapy. The result is a normal pregnancy.

For preventive purposes, the following recommendations should be followed:

1. Do not resort to abortion measures.
2. Follow the rules of intimate hygiene.
3. Take the proper amount of time to rest.
4. Follow all medical recommendations after surgery in the organs of the genitourinary system.
5. Avoid excessive physical activity and stressful situations.
6. Regularly undergo an examination by a gynecologist.
7. Treat all developing diseases as soon as the first symptoms appear.
8. Constantly strengthen the immune system.
9. Correctly organize the diet.
10. Enough time to be outdoors.

Conception with the growth of endometrial cells can occur, but it is problematic to bear a child with this pathology. Therefore, doctors recommend first of all to cure the disease. After that, you can safely plan a pregnancy. A woman has every chance to give birth to a healthy child.

Among the most common diseases gynecologists call uterine endometriosis, which is one of the causes of female infertility. To date, the causes of 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 an unambiguous answer, but with a detailed consideration of the topic, each for himself will have an understanding of this issue.

Endometriosis: what is it and how does it manifest itself?

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

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

The other extreme is to give any diagnosis a tragic coloring. Having learned about the pathology and the inflammatory process, they first of all 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 got pregnant with endometriosis.”

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

In medical practice, cases of such diseases have been recorded in young girls who did not have 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, the doctor can answer the question - is it possible to get pregnant after the treatment of endometriosis?

How is endometriosis formed and what affects

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

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

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. Someone is terribly afraid 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 prolonged periods are referred to as their "norm" and "treat" pain, and not the disease itself. With uterine pathology, many women try to live up to menopause and live on, in the hope that "it will pass by itself." They are more concerned about spotting (between periods and after sexual intercourse), as well as cycle failure, than their own health and why endometriosis interferes with pregnancy.

Mucosal nodes grow in the reproductive organs - this is genital endometriosis, but there is also an extragenital or external process. The foci of the disease are also detected in the abdominal organs, postoperative scars. All this negatively affects the reproductive female organs, affecting the uterus. Depending on the localization, physicians distinguish between the following varieties:

• retrocervical;
• peritoneal;
• extraperitoneal endometriosis.

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

Why you can’t get pregnant with endometriosis, what interferes

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 "gum", reducing the likelihood of fertilization. This is another reason why it is not possible to 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 adhesive processes. Such deviations from the norm are the cause of ectopic pregnancy. This is not to say that this is directly related to endometriosis, but it is like trees from a common root.
4. In medical practice, there are also frequent cases of extensive damage to the uterine cavity with endometriosis. Because of this, a fertilized egg cannot develop further without full implantation in the uterine wall. The development of the fetal egg below (in the cervical region of the uterus) leads to a miscarriage.

How to treat endometriosis to get pregnant

You should not be left alone with the problem, if there is no child in the family, it is recommended to be treated effectively. The hormonal background needs to be adjusted. But nature can take its toll, and endometriosis recurs, even during pregnancy.

Most often prescribed:

• drug correction (Dufaston 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;
• possible pregnancy after the treatment of endometriosis byzanne.

It is often difficult to get rid of the growth of the mucous membrane inside the uterus, but it is pregnancy that positively affects the state of these tissues. Some women on the forums indicate that they managed to get pregnant unplanned after the discovery of endometriosis in the peritoneum. At the same time, there were no problems with the "journey" of the fetal egg through the fallopian tubes. There were also many cases when a child was fully conceived, carried out and delivered after effective treatment and correction of the hormonal background.

Purposeful women succeed in everything, even giving birth to a baby with pathologies. So do not look for the answer to the question "how to treat endometriosis to get pregnant", it is better to ask your doctor!

The direct relationship between infertility and endometrioid disease is still not well understood. Therefore, the question of the possibility of pregnancy with endometriosis remains open.

It is known that 50-75% of women with various forms of this disease have one or another deficiency. reproductive function. What are their chances of conceiving and having a healthy baby?

Can you get pregnant with endometriosis

Of all the patients who applied to the centers of Assisted Reproductive Technologies (ART), every third suffers from endometriosis.

Possible reasons unsuccessful pregnancy with endometriosis:

1. Fallopian tube obstruction:
   • blockage or narrowing of the lumen of the fallopian tubes with germinated endometrioid tissue;
   • peritubal adhesions - overlapping of the lumen of the tube by the adhesive process;
   • violation of the conductivity of the fallopian tubes under the influence of toxic products of endometriosis.
2. Decreased functional ovarian tissue (decreased ovarian reserve):
   • due to destruction of the ovary by an endometrioid cyst;
   • due to excision of ovarian tissue during surgical treatment of the cyst.
3. Endometrial dysfunction, violation of embryo implantation in the uterine mucosa:
   • due to local imbalance of hormones and changes in the biochemical composition of the endometrium;
   • due to deformation and damage to the inner surface of the uterus by crypts and orifices of endometrioid passages.
4. Hormonal imbalance, violation of the menstrual cycle due to breakdown of the neuroendocrine system hypothalamus - pituitary gland - ovaries:
   • anovulation (3.5%);
   • LNF syndrome (2-3%);
   • secretion disorder gonadotropic hormones and synthesis of sex hormones in the ovaries;
   • hyperprolactinemia.
5. Changes in the immune and biochemical properties of the peritoneal fluid:
   • inactivation of spermatozoa in the abdominal cavity;
   • "poisoning", a decrease in the quality of eggs and embryos by the waste products of endometrioid tissue.
6. Early termination of pregnancy (miscarriage) due to convulsive muscle contractions of the uterus.
7. Stem cell pathology associated with the development of endometriosis.

However, endometriosis, for reasons unknown so far, does not always cause infertility. That's why:

• In mild forms of the disease, expectant management is recommended.
• If natural pregnancy does not occur within 5 years, ART should be considered.

External endometriosis and pregnancy

Medical treatment of infertility associated with external genital endometriosis is ineffective

With endometriosis of the fallopian tubes, endometrioid ovarian cysts (endometriomas), adhesions in the abdominal cavity, retrocervical endometriosis, the chances of spontaneous pregnancy are increased by a therapeutic and diagnostic operation: laparoscopy.

If laparoscopy is contraindicated, surgical intervention is performed by laparotomic access: through an incision in the abdominal wall.

Why does infertility treatment begin with surgery?

1. During laparoscopy (laparotomy), an audit of the pelvic cavity is made, adhesions are dissected, excised, cauterized, and the found foci of endometriosis, endometrioid ovarian cysts are removed.
2. The operation makes it possible to visually assess the condition of the reproductive organs of a woman and determine a number of indicators fertility index(EFA).

If the fertility index for endometriosis is low, then the patient after laparoscopic surgery is recommended don't waste time and immediately proceed to ART procedures: IVF, ICSI or IUI.

What is IVF
In vitro fertilization is a widely used method of assisted reproductive technology.

The essence of the method: fertilization (insemination) of eggs artificially extracted from the ovary with specially prepared partner's sperm "in vitro", or rather outside the woman's body, followed by transfer (replanting) of developing embryos into the uterine cavity.

What is ICSI
ICSI method - intracytoplasmic sperm injection. This is a modern modification of IVF.

The essence of the method: artificial fertilization of one egg with one sperm, by introducing it into the egg using the thinnest micromanipulation needle. The procedure is carried out under a microscope.

What is VMI
Intrauterine insemination is the oldest ART method that has not lost its relevance today.

The essence of the method: artificial introduction into the uterus of specially processed sperm obtained in advance.

Pregnancy after laparoscopy of endometriosis

Efficiency organ-preserving Surgical treatment of infertility in endometriosis is associated with the restoration of patency of the fallopian tubes and a decrease in inflammation in the pelvic region.

Greatest chance of spontaneous pregnancy after laparoscopy of endometriosis: first 12 months

If pregnancy does not occur within 2 years after surgery, the chances of its occurrence are extremely low.

Sometimes, immediately after surgical treatment, it is clear that there is no point in waiting for a natural pregnancy.

• The combination of external endometriosis with dysfunction of the fallopian tubes and peritoneal factor.
• Insufficient quality of the husband's sperm (subfertile sperm).
• Failure of previous fertility treatments.
• The woman is over 35 years of age.

Preliminary surgical treatment of external genital endometriosis increases the efficiency of ART up to 50-75%.

Endometriosis is a pathological process, the essence of which is a benign growth of tissue, morphologically and functionally similar to the endometrium (this is the inner mucous membrane of the uterine cavity). The disease provokes its growth outside the uterus (in the ovaries, bladder, intestines, lungs). Most often, endometriosis is diagnosed in women of reproductive age. It is dangerous because it inhibits the work of the ovaries (which means the absence of ovulation) and provokes the appearance of cysts, neoplasms. Therefore, endometriosis and pregnancy is a rather dangerous combination.

Causes of endometriosis

Unfortunately, modern medicine cannot name the reasons for the development of this disease with full confidence. But the risk factors are precisely known:

• genetic propensity;
• menstrual irregularities;
• at risk are nulliparous girls and women who have had one birth;
• frequent abortions, diagnostic curettage of the uterus;
• hormonal imbalance;
• prolonged use of intrauterine contraceptives.

Also considered risk factors are dysmenorrhea, sexual intercourse and sports during menstruation, the constant use of tampons. All this complicates the free outflow of blood from the uterus during menstruation and can cause it to enter the fallopian tubes, the abdominal cavity, which contributes to the development of the pathological process.

Symptoms of endometriosis

Quite often, the disease is asymptomatic, and it is determined only by ultrasound or during laparoscopy. Most women do not even realize that their unsystematic pain in the lower abdomen or fatigue can somehow relate to the health of the reproductive system. But there are symptoms that should not be ignored. It:

• chronic pain in the lower abdomen;
• pain during ovulation, sexual intercourse;
• painful urination during menstruation;
• bowel problems and painful bowel movements;
• bloody issues;
• chronic weakness;
• problems with conception.

The most important clinical symptoms of the disease are pelvic pain, menstrual irregularities, infertility, dysfunction of the pelvic organs.

Stages of development of endometriosis

This process occurs against the background of a violation of hormonal, immunological balances or in the case of a genetic predisposition to the disease. The frequency of endometriosis in women of reproductive age reaches 59%, and in operated women 27%.

The stages of the development of the disease depend on the depth of damage to healthy tissue. The American Fertility Society has developed its own classification of the external form of the endometrium, according to which this disease has 4 stages:

• minimal (estimated at 1-5 points);
• easy (6-15 points);
• moderate (16-40 points);
• severe (more than 40 points).

Diagnosis of endometriosis

How to treat endometriosis? First you need: diagnosis and in-depth analysis of the clinical picture, a bimanual gynecological examination (palpation of the internal organs of the pelvis).

1. Bimanual gynecological examination. This research method will help the doctor evaluate the size of the uterus, its density, shape, identify seals in the retrocervical region, and the presence of tumors.
2. Colposcopy and cervicoscopy. These procedures will clarify the place and form of endometriosis lesions of the vaginal part of the cervix and the mucous membrane of the cervical canal (in this case, an additional examination will be carried out using a fibrohysteroscope).
3. ultrasound. Ultrasound is the optimal and widely available screening method for examining women with different stages of endometriosis.
4. The method of spiral computed tomography. It will allow you to accurately determine the nature of the pathological process, its localization, the relationship with other organs. It will also help to clarify the condition of the pelvic organs, the presence of neoplasms.
5. Hysteroscopy. Using a hysteroscope (optical system), you can examine the walls of the uterine cavity and assess the patient's condition. The method will help the doctor to identify and evaluate changes in the relief of the uterus, the presence of scars, crypts.
6. Laparoscopy. With it, you can assess the condition of the tissues and the degree of their damage. Through a small incision in the abdomen, the doctor introduces a special device with a powerful optical system, which allows you to examine all the organs of the abdominal cavity, the uterus, and diagnose pathological processes.

Endometriosis and conception

Endometriosis and pregnancy during this disease have been studied by doctors for a long time. According to research by the American Fertility Society, laparoscopy data states that 20-50% of infertility cases are recorded in women suffering from endometriosis.

Although endometriosis is considered one of the causes of problems with conception, spontaneous pregnancy is possible even with a severe stage of the disease. Although usually the disease provokes anatomical changes in the mucous membrane of the uterus or other pelvic organs, which often leads to damage to the fallopian tubes, adhesions, lack of ovulation, and the formation of cysts. In addition, endometriosis has a tendency to relapse, and this negatively affects the reproductive system and conception.

Pregnancy with endometriosis of the uterus: what is the danger and how to avoid it

It is possible to get pregnant during endometriosis, although the chances of success are not very high. After the course of treatment, the most favorable period for conception lasts a year. After this time, the risk of relapse increases. Pregnancy after endometriosis is quite real, but the expectant mother needs to carefully monitor her well-being and visit the doctor regularly.

The fact is that endometriosis provokes a violation of blood circulation in the walls of the mucous membrane of the uterus, a lack of progesterone, which prevents the normal fixation of the embryo. Therefore, there is a possibility of miscarriage in the early stages. Later, a placenta that is not affected by endometriosis will form, and the risk will decrease. Taking progesterone medications and being closely monitored by your doctor will save you a lot of trouble during pregnancy with endometriosis.

Treatment of the disease by pregnancy: myth or truth?

If you have been diagnosed with this pathology, and you cannot, but want to get pregnant, then the sooner you see a doctor, the better. Treatment of endometriosis by pregnancy, contrary to popular belief, is impossible. Of course, the hormonal background of the expectant mother changes a lot, and due to the increased production of estrogen and progesterone, endometriosis foci are likely to be suppressed. But, unfortunately, there can be no talk of a complete recovery. Endometriosis and pregnancy are incompatible with each other in more than half of the cases.

Management of endometriosis before and after pregnancy

Unfortunately, so far there is no unified treatment strategy. A gynecologist in a situation of "endometriosis and pregnancy" develops an individual scheme of examination and treatment, focusing on the stage and localization of the lesion, clinical manifestations, and tolerance to hormonal drugs.

Usually, conservative treatment is used for patients of reproductive age with an asymptomatic form of the disease, infertility. In especially severe cases (when surgical and medical methods do not help), the foci of endometrial lesions are treated surgically.

In the event that the symptoms of the disease do not cause discomfort and it does not progress, then the doctor will most likely suggest that you be monitored regularly and not take drastic measures. Especially since endometriosis usually goes away after menopause. If something worries you, but the problem of the inability to conceive is not relevant, then the doctor will develop an individual drug treatment regimen for you.

Treatment options for endometriosis

One of the barriers to motherhood and health can be endometriosis. Treatment of this disease is carried out using the following methods.

1. Laparoscopy (surgery). How to treat endometriosis? Laparoscopy involves the destruction of adhesions and endometrioid nodes, tissue lesions that reduce the patency of the fallopian tubes. The percentage of the effectiveness of the procedure reaches 84%, especially in the case of a mild form of the disease.
2. Medical treatment. Drug therapy provokes the absence of ovulation and can negatively affect the embryo, so for women who want to get pregnant, it is not advisable (except for the hormone gonadotropin - it improves ovulation).

Most often, combined oral contraceptives (progesterone preparations) are recommended. The mechanism of action of drugs is that their components provoke inhibition of ovarian function, lack of ovulation and menstruation. Tissues affected by endometriosis stop bleeding, which prevents the formation of adhesions, cysts, and inflammation. The negative side is the presence of side effects.

If all methods have been exhausted, and pregnancy does not occur, there is an alternative option - assisted reproductive technologies.

Although endometriosis in almost 50% of cases provokes infertility, but this is not a sentence. With timely treatment and qualified treatment, the success rate is quite high. In addition, there is an alternative to classical treatment - assisted reproductive technologies. Medical care and self-confidence will certainly help to defeat the disease. Remember that pregnancy with endometriosis is possible!

Endometriosis is the appearance of cells of the inner layer of the uterus (endometrium) in atypical places: on the peritoneum, in the ovaries, fallopian tubes, wall and cervix, in the bladder, rectum and other organs and tissues.

Why is this happening? Causes of endometriosis

Doctors do not have a definite answer to this question. In general, the picture looks like this.

The inside of the uterus is lined with a mucous membrane called the endometrium. This mucosa consists of two layers - basal and functional. The functional layer is shed every month during menstruation, unless pregnancy occurs. The next month, the endometrium grows again due to the multiplication of cells of the basal layer, under the influence of ovarian hormones, in particular, estrogens and progesterone.

Estrogens (hormones of the first half of the menstrual cycle) contribute to the growth of the inner layer of the uterus and the maturation of the egg. After ovulation, the amount of estrogens decreases, the ovaries begin to secrete progesterone, which inhibits the growth of the endometrium and promotes the development of glands in it, preparing it for the introduction of a fertilized egg. If pregnancy does not occur, then the level of estrogen and progesterone falls, the endometrium is rejected by the uterus, and this is externally manifested by menstruation. Discharge during menstruation is a mixture of blood and fragments of exfoliating endometrium.

So, for the occurrence of endometriosis, at least two factors are necessary: ​​a violation of the hormonal background and a decrease in immunity.

Hormones in endometriosis: an imbalance is provided

Endometriosis does not develop in a woman's body if she does not have a malfunction in the hormonal system. The regulation of the female reproductive system is controlled by many hormones produced by the glands of the brain (hypothalamus, pituitary gland) and ovaries. Moreover, the ovaries themselves are under the control of the hypothalamus. Hormones in endometriosis behave “wrongly”: the ratio of estrogen and progesterone is disturbed in the body. This leads to the suppression of ovulation and the growth of the endometrium, which is then rejected, causing bleeding. Individual cells of the immature endometrium are thrown into atypical places - and foci of endometriosis are formed.

Immune dysfunction and endometriosis

Another cause of endometriosis is a violation of the immune system. The human immune system is designed in such a way that it protects the body from any "unusual" proteins, destroying "foreign" proteins of infections, foreign bodies or tumor cells. In the same way, it destroys cells that are not characteristic of a particular tissue, in particular, endometrial cells that have fallen into “inappropriate” places for them. In almost all women, during menstruation, the discharge not only goes out (through the vagina), but is partially thrown through the pipes into the abdominal cavity, uterine wall, ovaries, and also into the blood and spread throughout the body. Normally, menstrual flow that enters the abdominal cavity is quickly destroyed by special protective cells. Endometriosis occurs when the immune system stops recognizing endometrial cells in other tissues, allowing them to multiply freely anywhere.

After the endometrial cells take root in a new place, they continue to exist according to the laws of the menstrual cycle as they did while in the uterine cavity - in the first half of the cycle they actively multiply and grow, and when menstruation comes, they are rejected into the abdominal cavity, leading to the formation of new foci of endometriosis. If endometrial tissue enters the ovary, then endometrioid benign cysts can form in it. Endometriosis of the body of the uterus (adenomyosis) occurs when endometrial cells are introduced into the muscular layer of the uterus. In rare cases, foci of endometriosis can be found in a wide variety of organs and tissues of the body. So, there is endometriosis of the kidneys, ureters, bladder, lungs, intestines. This is due to the fact that fragments of endometrial tissue are carried throughout the body by the lymphatic or circulatory system.

During pregnancy, menopause and menopause, endometriosis foci undergo a reverse process, which leads to an improvement in the woman's condition.

Symptoms of endometriosis: if the stomach hurts ...

In rare cases, a woman does not even suspect that she has endometriosis, since it can proceed without showing itself at all. But much more often this disease seriously disturbs well-being. One of the main symptoms of endometriosis is pain in the lower abdomen associated with the menstrual cycle. They subside at the beginning of the cycle, grow towards its end, becoming especially strong during menstruation. The pain is most often bilateral, sometimes accompanied by a feeling of pressure in the rectal area and can be given to the back and leg. Discomfort and pain can also occur during sexual contact, as well as during bowel movements. Sometimes the pains are so pronounced that sexual life becomes impossible. Their cause lies in the irritation of the “menstruating” endometrial foci of the nerve endings of the peritoneum. This causes the formation of adhesions (connective tissue strands) in the abdominal cavity, which, in turn, lead to constipation up to intestinal obstruction, as well as frequent, painful urination. Almost all women with genital endometriosis complain of pain during sexual intercourse. Another sign of this disease is prolonged periods, dark spotting before and after menstruation, as well as bleeding between periods. The cycle becomes irregular or shortened, and menstruation is profuse, clotted, and painful. The woman constantly suffers from blood loss, which leads to anemia. And endometriosis of the uterus is manifested by bloody discharge after sexual contact.

Often this insidious disease is also reflected in the emotional state of a woman: constant pain, violations in the sexual sphere, difficulties with conception lead to irritability, imbalance and depression.

Planning for pregnancy with endometriosis

It is believed that endometriosis and pregnancy are not very compatible. Endometriosis can interfere with the maturation of the egg and its release into the fallopian tube (ovulation). It is clear that all this cannot but affect the possibility of conception, and the chances of getting pregnant with endometriosis, unfortunately, decrease. In addition, with a long course of endometriosis, adhesions often form in the genitals, which increases the risk of infertility. Especially dangerous in this regard are adhesions in the fallopian tubes and ovaries, which create an obstacle to the advancement of the egg, which makes it impossible for it to meet with the sperm and conceive.

However, endometriosis is not a "guarantee" of absolute infertility. There are proven facts of the accidental discovery of this disease in women who have never had problems conceiving. Also, many women manage to finally get pregnant after endometriosis.

How is the diagnosis made?

The doctor is able to suggest a diagnosis of endometriosis during a routine gynecological examination: for example, he can see its focus on the cervix or feel painful seals in the vagina. The doctor also draws attention to pain, their connection with menstruation and sexual life. To confirm or clarify the diagnosis, pelvic ultrasound, magnetic resonance imaging, colposcopy (examination of the vagina and cervix using a microscope), hysteroscopy (examination of the uterine cavity using a special hysteroscope device) and laparoscopy are used. The latter method is the "gold standard" for diagnosing endometriosis. This is a gentle surgical operation that allows you to examine the abdominal cavity under magnification (using a special device - a laparoscope) through small holes in the abdominal wall. In fact, only with the help of this method it is possible to see the foci of endometriosis and take a biopsy (pieces of tissue) from them to confirm the diagnosis. Without laparoscopy, the presence of endometriosis can only be assumed.

Treatment and planning of pregnancy after endometriosis

It should be noted right away that the treatment of endometriosis is a long process. Conservative, operative and complex methods can be used. When choosing a method of treatment, the specialist takes into account the age of the patient, the severity of the course of the disease, whether the woman is planning a pregnancy after endometriosis.

With the conservative treatment of endometriosis, hormonal drugs are prescribed in the first place.

Depending on which part of the hormonal regulation was found to fail, the doctor will select the appropriate medication to correct the violation.

Be sure to treat iron deficiency anemia with iron supplements and a special diet. Immunostimulating, analgesic and hemostatic drugs are also prescribed. It is almost impossible to eliminate endometriotic lesions, but treatment allows you to cope with pain and put your menstrual cycle in order, which increases the chances of a woman becoming pregnant after endometriosis.

In some cases, for example, when adhesions form due to endometriosis, one has to resort to surgical treatment. Most often, laparoscopy is used, which allows the least traumatic removal of foci of affected tissue and adhesive formations.

In the treatment of endometriosis, conservative and surgical treatment is often combined. Unfortunately, it is rarely possible to completely get rid of this disease, treatment only allows you to stop the disease, which gives a temporary head start for pregnancy.

Endometriosis and pregnancy

After conservative treatment, it is recommended to plan conception no earlier than 3 months after the course of therapy, so that the body of the expectant mother can fully recover.

Operative intervention, on the contrary, suggests an early onset of pregnancy after endometriosis (unless a combined course is prescribed - a combination of surgical and hormonal treatment). Many doctors advise that before performing surgical treatment of endometriosis, make sure that infertility is not caused by other disorders. If there are several possible causes of infertility, it is recommended to first eliminate all other problems and only then perform surgery for endometriosis. This is due to the fact that the effect of the operation does not last long - the chances of pregnancy after endometriosis increase only in the first 6-12 months after surgery.

On average, 90% of women treated conservatively for mild to moderate endometriosis manage to conceive without surgery within 5 years.

The course of pregnancy with endometriosis

Although it is believed that pregnancy and endometriosis are not very compatible, it is still possible to get pregnant with this disease, and even without treatment for the disease. During pregnancy, endometriosis, as a rule, is not treated, but is dealt with after the birth of the baby.

The only exceptions are cases when an endometrioid ovarian cyst is found in a future mother: if there is a danger of its rupture or torsion, then an operation is planned, which is usually performed at a period of 16–20 weeks of pregnancy (this period is the safest for the fetus).

The combination of pregnancy with endometriosis requires special attention of doctors. Pregnancy often has to be supported with hormones to prevent miscarriage. The threat of interruption may occur in the first and second trimesters due to a lack of the female sex hormone progesterone in the body, which is necessary during this period for the proper development of pregnancy and suppression of uterine muscle contraction. After the formation of the placenta, the likelihood of a miscarriage decreases. By itself, endometriosis no longer threatens the fetus and does not affect its development in any way.