IVF (in vitro fertilization) is usually the best treatment plan for patients who struggle with infertility caused by endometriosis. Endometriosis is a gynecological condition of the female reproductive system that occurs when endometrial tissue grows in other areas of the body. Endometrium, or the lining of the uterus, is produced each month to support the development of a fertilized egg. If conception does not occur, the endometrium is shed during a menstrual cycle.
The problem occurs when endometrial tissue moves out of the fallopian tubes and into the abdomen. Sometimes, the tissue attaches to other organs, causing abdominal pain. When the tissue is bleeding and there is no way to exit the body, women may experience inflammation and pain. According to the statistics, about 30% to 50% of endometriosis patients have difficulty to conceive.
We understand it is normal for women affected by this condition to worry about the impact that endometriosis may have on their fertility and their chances of getting pregnant. Understanding endometriosis and the treatment options available to you is the first step on your journey to parenthood.
We’ve created this guide to help you feel more empowered to seek professional help and navigate your IVF treatment in Cyprus with more ease.
What Causes Endometriosis
The exact causes of endometriosis are not certain. This is because the etiology (causes) of endometriosis are complex, depending on multiple factors. However, scientists have discerned multiple theories regarding the origin of this condition, including:
- Abnormal menstrual flow. This condition happens when menstrual blood containing endometrial tissue flows back into the pelvic area. This phenomenon is called retrograde menstruation. The dislocated endometrial tissue attaches to the pelvic walls and organs and continues to grow there, causing bleeding and pain.
- Peritoneal cell transformation. Endometriosis may be caused by the transformation of peritoneal cells — cells that form the lining of the abdominal cavity — into endometrial cells.
- Embryonic stem cell transformation. Estrogen may promote the transformation of embryonic stem cells — undifferentiated inner mass cells of a human embryo — into endometrial cells.
- Endometrial cell transport. Endometrial cells may be moved to other parts of the body through the blood vessels or tissue fluid.
- Scarring. Endometrial cells may implant into a scar tissue after surgery, such as a hysterectomy or C-section.
- Immune system disorder. Endometriosis may trigger the immune system to attack endometrial tissue that’s growing outside the uterus.
Is Endometriosis Hereditary
Endometriosis can occur during fetal development when the endometrial cells grow outside the uterus in a growing fetus. This is believed to be caused by dislocation of primitive endometrial tissue during organogenesis (formation of organs). Usually, puberty triggers the symptoms as the estrogen levels get higher. A study found that endometriosis can also be hereditary in women with a family history of endometriosis. The chances are that if your mother had endometriosis, you are more likely to be affected by this condition than those who do not have a family history of endometriosis.
What are the Stages of Endometriosis
Endometriosis can be minimal (stage I), mild (stage II), moderate (stage III), and severe (stage IV). Factors that determine the stage of endometriosis include location, extent, and depth of the endometrial implants, presence, and severity of scar tissue, and the presence and size of endometrial cells in the ovaries. Moderate and severe endometriosis typically leads to the formation of pathological cysts. These are formed when endometrial tissue grows on the surface of the ovary or deep inside, resulting in severe scarring that imposes a serious risk on fertility.
What are the Signs of Endometriosis
Endometriosis does not always generate symptoms. In this case, it is referred as to silent endometriosis. But when it does produce symptoms, you may expect to have:
- Pain in the pelvic area that occurs at menstruation. Pain can be present in other times during the cycle, such as ovulation or during sexual intercourse. Those who suffer from bowel endometriosis can experience pain during a bowel movement.
- Infertility. Scarring and adhesions can block the fallopian tubes or uterus, making it difficult for the sperm to travel to the fallopian tubes to fertilize the egg. Endometrial tissue growing in the ovaries can prevent the release of an egg.
- Pain during a pelvic exam. Women who experience pain during a pelvic exam (evaluation of reproductive organs by a gynecologist) may be suspected to have endometriosis.
Other symptoms of endometriosis may include:
- diarrhea and/or constipation
- chronic fatigue
- irregular or heavy menstruation
- painful urination
- bloody urine
What Does Endometriosis Feel Like
The major problem of endometrial cells growing in other areas of the body is that they swell and bleed just like the uterine lining does every month during menstruation. This can cause inflammation and pain because the tissue cannot exit the body.
The good news is that pregnancy offers some relief to the symptoms generated by endometriosis. The hormones produced during pregnancy cause most of the endometriosis to disappear. Additionally, breastfeeding can prevent endometriosis from recurring. After breastfeeding, therapy using birth control pills may be recommended until the next pregnancy. These pills can prevent the growth of endometrial tissue and help relieve the pain.
How to Diagnose Endometriosis
There are a few options that can help doctors diagnose endometriosis, including:
- Pelvic exam (visual and physical examination of a woman’s reproductive organs).
- Rectovaginal exam (used to supplement a pelvic exam).
- Ultrasound imaging can help to rule out other pelvic diseases and may suggest the presence of endometriosis.
- Laparoscopy or laparotomy. Laparoscopy is performed using a thin instrument (laparoscope) for visualization to inspect the abdomen and pelvis. Endometrial implants can then be directly seen. Laparotomy is a surgical procedure that involves an incision in the lower abdomen to look for endometrial tissue.
What is the Treatment for Endometriosis
Treatment options may include surgery and/or assisted reproductive technology (ART) such as in vitro fertilization (IVF). Endometriosis treatment may include symptom management and/or fertility enhancement. The choice of treatment will depend on your age, stage of endometriosis, other fertility issues, and personal choice. Your treatment plan will also depend on whether endometriosis alone is the cause of infertility. Our euroCARE IVF doctor will review your medical history, arrange fertility testing, and discuss the available treatment options.
How to Get Pregnant with Endometriosis
The first step in preparing yourself for pregnancy is to have a consultation with our euroCARE IVF fertility doctor who will arrange a fertility assessment. You can bring previous medical records to help our doctor create a more customized treatment plan for you. During your initial consultation, you will get to know our medical team and will discuss important issues related to your condition and pregnancy. We are happy to educate you and respond to all concerns related to the IVF process.
IVF in Cyprus for Endometriosis
In vitro fertilization (IVF) for endometriosis is the most effective treatment that provides the best odds for pregnancy. IVF treatment in Cyprus is generally recommended if you:
- Have an advanced stage of endometriosis (stage III or IV),
- Are over 35,
- Have other fertility issues such as low ovarian reserve,
- Prefer to go directly to an IVF cycle rather than undergoing other less effective treatments.
IVF for endometriosis provides hope for many women who have been struggling to have a healthy pregnancy. The prognosis is surprisingly good. Our fertility team provides special monitoring during the treatment cycle to help you manage your fertility drugs and prepare your body for pregnancy. Usually, pregnancy brings relief for the pain caused by endometriosis. Once the baby is born, you will probably need to resume your therapy for the management of symptoms.
How to Increase Chances of Pregnancy with Endometriosis
IVF for endometriosis is the most commonly used assisted reproduction technique to help endo patients start a family. Fertility medication used in IVF treatments contain hormones that stimulate the growth of multiple eggs. Having more eggs for fertilization offers a wider choice of embryos for implantation. PGS (preimplantation genetic screening) test in Cyprus is another way to enhance pregnancy success.
PGS testing in Cyprus
PGS testing in Cyprus can help you save time, money and heartache. It is a genetic test performed on embryos that were created with IVF to help you have a healthy baby. The PGS test:
- Is performed before embryo transfer.
- Identifies chromosomally normal embryos for transfer.
- Significantly increases pregnancy success.
- Reduces miscarriage caused by chromosomal abnormalities within the embryos.
Women who are producing poor-quality eggs or/and have a genetic condition that can be passed on to the child may be advised to have PGS testing carried out during their IVF treatment in Cyprus.
Lifestyle
Lifestyle is an important factor when you are trying to get pregnant. A healthy lifestyle includes:
- Maintaining a normal weight.
- Eating a well-balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
- Exercising on a daily basis (e.g. walking, jogging, swimming, yoga, Tai Chi, etc.)
Preparing your body and mind for the upcoming IVF journey is important to increase your chances for IVF success. Find useful tips from our euroCARE IVF fertility specialist on how to maximize egg production and prepare your body for pregnancy success.
IVF for Endometriosis Success Rates
Our medical practice and a number of studies have shown that IVF programs for endometriosis produce high success rates. Success with IVF is, however, a personal thing, which depends on many factors including your age, stage of endometriosis and location of endometrial tissue in the body, other fertility issues, ovarian reserve, and lifestyle. A study found that 56.7% of the women with stage III/IV endometriosis were pregnant using IVF. The corresponding success rates were 67.7/81.6% for patients with endometriosis stage I/II respectively.
IVF for Endometriosis at euroCARE IVF in North Cyprus
Endometriosis is a challenging condition. So may be infertility caused by this diagnosis. With the right help, endometriosis does not have to stand on your way to becoming parents. If you do decide to undergo IVF, our euroCARE IVF fertility expert will create a personalized treatment plan tailored specifically to your condition and needs and will carefully monitor your health during the ovarian stimulation phase of the IVF process. IVF is an extremely effective treatment for patients with endometriosis. Many women have managed to circumvent this medical condition and have started a family. Get in touch with our expert IVF team to help you find the most suitable treatment options!
Resources:
Reproductive Biomedicine Online Journal