In the last 10 years of consulting for couples with infertility issue , our statistics show that around 10-12% infertility cases are due to endometriosis. Ofcourse this statistics are from the couples who visited us for the endometriosis treatment. Most of these clients have undergone heavy hormonal treatment and IUI treatments before approaching us. Sometimes it takes 2-3 months of treatment to just clear off the effects of these hormones. Many of these ladies are confused, as their hormonal levels are within normal limits, eggs are released on time, inspite of that why is there, the inability to conceive and how endometriosis can stop them from natural conception.
Infertility can be one of the consequences of endometriosis. Women are not only dealing with a debilitating disease but they are also in fear of not being able to have children.
If you have endometriosis, it may be more difficult for you to become pregnant. Up to 30% to 50% of women with endometriosis may experience infertility. Endometriosis can influence fertility in several ways: distorted anatomy of the pelvis, adhesions, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, changes in the hormonal environment of the eggs, impaired implantation of a pregnancy, and altered egg quality.
The fallopian tubes and ovaries may adhere to the lining of the pelvis or to each other, restricting their movement. The scarring and adhesions that takes place with Endometrisois may mean that the ovaries and fallopian tubes are not in the right position, so the transfer of the egg to the fallopian tubes cannot take place. Similarly, Endometriosis can cause damage and/or blockage to the inside of the fallopian tube, impeding the journey of the egg down the fallopian tube to the uterus.
Another factor which could cause infertility for women with Endometriosis, may be the over-production of prostaglandins. These are hormones which play and important role in the fertilization and implantation of the embryo. An excess of prostaglandins may interfere with these processes.
Because Endometriosis often causes painful intercourse, couples may fail to have intercourse during the woman’s most fertile time, which will obviously impede the possibility of conception.
A look at some of the possible causes of Infertility due to endometriosis
Abdominal Adhesions and Infertility
As the Endometriosis implants grow and develop in the abdomen, the body tries to surround them with fibrous connective tissue (scar tissue). The body does this in an attempt to isolate the implants and prevent them from doing harm. Adhesions can also be formed during surgery when abdominal tissue is traumatized.
If the adhesions caused by Endometriosis pinch off the fallopian tube or if they cause blockage to the opening of the fallopian tube, they could obstruct the merger of egg and sperm and prevent fertilization and conception. Also ectopic pregnancy is more common with Endometriosis, if the embryo can’t travel to the womb. This type of obstruction can be easily diagnosed and surgically corrected.
Secretions from implants
The normal Endometrium which lines the womb is a very active and vital tissue that secretes a wide variety of nutrients and hormones required for normal conception. The endometrial implants also secrete these same substances, but instead of depositing them into the lumen (center) of the womb as normal, the endometrial implants release their chemical secretions into the abdominal cavity. Some of these substances are potent hormones which could interfere with fertility.
One major group of hormones secreted by the normal endometrium is that of the prostaglandins. Prostaglandins are oil-based hormones found in nearly all the tissues of the body and are required for many bodily processes, including several stages of the menstrual cycle and pregnancy.
Prostaglandins are required for ovulation, regression of the corpus luteum (i.e., ending the monthly menstrual cycle), sperm motility, immune interaction, contraction of the uterus at birth and menstrual cramps. Endometriosis implants and the endometrium of the uterus are the richest source of prostaglandin production in the body.
However, the problem with Endometriosis implants includes:
– Prostaglandins are released into the abdomen instead of inside the womb
– Prostaglandins release by the implants seem to be out of phase with their release by the uterus. Prostaglandins are produced at the wrong time sending the wrong message.
If a women is a few days pregnant then the Endometriosis implants producing prostaglandin would incorrectly signal the ovary to start a new menstrual cycle, causing the womb lining with the implanted egg to be expelled – and the consequence is an early miscarriage.
The most common time for a miscarriage to occur is during the first three months of pregnancy. During this time, the embryo is developing into a fetus and is undergoing dramatic changes, including the formation of most of its internal organs. This is a critical period of development that requires an appropriate nutrient-rich environment, a healthy placenta and a very delicate balance between the various hormones involved in pregnancy.
Regardless of whether or not there is a high miscarriage rate in Endometriosis patients, it is imperative to eat the right sort of nutrient-rich food to try to ensure the maintenance of a pregnancy. Nutrition in both parents, even before pregnancy has a profound effect on the state of the egg and sperm, as well as on the nature of the secretions within the peritoneal cavity. Choice of foods, particularly fats and oils, may be a crucial factor as these affect the production of prostaglandins, cell membranes, steroid hormones, and neurotransmitters etc.
Fertility and the Immune System
In order to achieve pregnancy, sperm has to enter the body. This sperm can be judged as ‘alien’ by a women’s immune cells, because it is ‘non-self’. If pregnancy is achieved, the women’s immune system has to adapt to the presence of ‘alien’ tissue growing inside her for nine months.
However, there will be some mechanism in nature, which tells the female immune system that this alien tissue is not a danger, in order to avoid damage to the embryo. Perhaps when the immune system is malfunctioning in Endometriosis, this mechanism fails and causes an immune attack on the embryo and sperm, thought to lead to infertility.
Any treatment for endometriosis should involve :
– rebalancing of hormones, boost the immune system and diminish active Endometriosis
– changing the diet to achieve optimum health
– natural homeopathy treatment can work wonders to restore health and bring the body back into balance and surgery may rarely be required to repair damaged tissue and organs caused by Endometriosis, to restore them close to their original functions.