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Endometriosis and Trying to Conceive

by Lori Ramsey | 30 Comments

The diagnosis of endometriosis does not mean permanent infertility. It is possible to conceive with endometriosis. The fact is endometriosis affects 5% of all child-bearing females. This means that there are a good number of endometriosis patients who will have problems trying to conceive.

What is Endometriosis?

Let's take a look at what endometriosis is, the symptoms and how it's diagnosed and treated and how it effects conception. Endometriosis is a growth of the endometrium, the area inside the uterus known as the uterine lining, only it grows all over the pelvic cavity in and on the fallopian tubes, on the ovaries and the outside of the uterus. In some cases, it can spread to other organs.

Endometriosis can cause very direct symptoms, or it can grow symptom free. If symptoms are present there can be pelvic pain, painful intercourse, painful urination, unusually heavy menstrual bleeding and spotting prior to menstruation. Severe menstrual cramps are also an indicator in about 25-35% of endometriosis patients.

Diagnosis and Treatment

Endometriosis is diagnosed initially through an ultrasound. An ultrasound is a device which emits sound waves when the transducer is placed on the lower abdomen. If endometriosis is suspected, a laparoscopy will confirm it. A laparoscopy is the insertion of a tiny camera through a small incision in the lower abdomen or through the vagina and cervix.

Treatment for endometriosis varies. The best treatment/cure for it, ironically, is pregnancy. It's during pregnancy that the growth of the endometrium stops. However, it's this growth that can hinder conception from occurring and causes problems with ovulation and the luteal phase. This is when other treatments may be needed first. These include birth control pills and ovulation suppressions such as Danazol and Lupron. If these don't work, laser treatments can be tried. However, laser treatments is usually tried first if pregnancy is desired.

Once the endometrium growth is contained, the other affects of endometriosis have to be dealt with. These are ovulation and the luteal phase. Endometriosis thrives when ovulation occurs, so in order for conception to happen, the growth has to be taken care of and then there's a small window of opportunity for conception to occur before the growth returns. The luteal phase, the time from ovulation to menstruation, has to be at least ten days long. In endometriosis the luteal phase is usually shorter or plagued with spotting. This can be remedied with progesterone or Clomid (a fertility drug) if need be.

When dealing with endometriosis, it's often advised to have a hysterectomy once the desired number of pregnancies has been achieved. Endometriosis gets worse as time goes on and what once was pain-free may become painful eventually. If endometriosis is suspected, it is advisable to let the physician know that pregnancy is desired, so the correct measures can be taken to ensure that conception occurs.

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Lauren Jun 7, 2018 11:12:43 AM ET

I have endometriosis and i also have hypothyroid. i had been trying for a baby for about 5-6 years. after having 2 surgeries, all sorts of meds, injections in tummy to stop ovulation, nothing stopped or helped with pain etc. last august i went on holiday to tenerife to try and relax and forget what was going on in my body! on my bday beginning of sept i found out i was pregnant! this was a shock to me and a massive blessing after thinking it was never going to happen! it wasn't the best pregnancy and i was ill a lot of it,. but today my baby is now 5wks old! he is my miracle baby, such a blessing! i can't say how my endometriosis is right now as still recovering from labor ! but all i can say is don't give up, it can happen. positive thoughts.

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Guest Oct 7, 2016 03:59:36 AM ET

Hello everyone, i had endometriosis and hydrosalpinx on my ovary. march 2016, i had a laporoscopy. doctor made both of my tubes open. after 3 months of operations,we tried to have a baby. but, i did not conceive. now after 6 months, my bodys progesterone level has become very low. my hubby and i are staying far apart because of work. we can meet again in 2 months. we are helpless. can you suggest to us, what should we do? can i conceive naturally in time being?

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Angela Sep 17, 2016 12:46:37 PM ET

I'm 22yrs old and back in february this year i had a ectopic pregnancy. i went for a hesteroscopy, laparoscopy and d&c. ;in june i was diagnosed with endometriosis. what could my chances be of conceiving? and how long does it usually take after getting the surgery's i've had to conceive?

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Angela Sep 15, 2016 06:57:44 PM ET

I'm 22 years old and back in february of this year i had an ectopic pregnancy. i went for a hesteroscopy, laparoscopy and d&c. in june i was diagnosed with endometriosis. what could my chances be of conceiving? and how long does it usually take after getting the surgeries i've had to conceive?

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emma Mar 4, 2015 04:52:01 PM ET

Hi all i was diagnosed with pcos 8 years ago. then, last year with endometriosis. last year, me and partner both agreed for me to come off the pill, and if baby happens it happens, rather than stressing about trying. 18 month on and i have still not fallen pregnant. any advice would be helpful.

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Celena Jan 22, 2015 11:15:14 AM ET

I was just diagnosed with stage 1 endometriosis. i have been told for the past 4-5 years that i could possibly have it. but, just yesterday, i was diagnosed with it, and had a laparoscopy done. i have suffered from extreme pain and irregular periods for years. me and my boyfriend defiantly know we want a baby. i was just wondering what my best options are, if anyone who knows a little more about this. thanks!

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Jenny Oct 8, 2014 08:41:25 PM ET

Endometriosis is rarely ever detected using an ultrasound, it is only diagnosed after surgery... and pregnancy rarely cures endo. also, the endo can persist after a hysterectomy if it is not treated at the same time. it feeds off of estrogen. the only thing that may get rid of it completely is removing the ovaries and uterus. if you take hormone replacements the remaining endo will stay "alive". it's not only the endo that can cause pain, but adhesions can as well. if you have endo you are more likely to have fibromyalgia, irritable bowl syndrome, diabetes, hypothyroid... and other autoimmune disorders. i've had 3 ablation surgeries which did not work, and one excision surgery which did help. i also had emergency surgery when endo nearly made my appendix burst. i still have pain. excision surgery is the best to remove endo, but don't expect miracles. many still have pain after, and the doctors will not tell people realistic outcomes of treatment. it's not entirely their fault, much is unknown about this disease. don't let your doctors minimize your pain. you are not crazy. join endometriosis forums and learn everything you can... so many people suffer with this, and it is inexcusable that the pain we feel is not recognized nor treated as it should be.

Guest Nov 11, 2014 06:09:36 PM ET

Great post. i agree with what has been said. well done jenny.

Tami Dec 21, 2014 08:53:35 AM ET

Very well written jenny. it's scary how misinformed people can be about this disease.

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Geen Nov 10, 2013 01:12:58 AM ET

I was diagnosed with endometriosis 10 years ago and since then it was long lasting battle. i have stage iii recurring cysts. at first i was scheduled for a hysterectomy and my gyno removed 8 cm bundle and 5 cm bundle of endometrium from each ovary. i was on decapeptil injections for six months to stop regrowth of cysts since i didn't want to get pregnant at that time. after 2 years of failing attempts to conceive, i tried insemination and it was another failure. i was scheduled for another surgery in march 2007 having a laparoscopy this time. gyno decided i had no choice but to go to ivf for faster alternative. in april 2007 i tried my first ivf and was pregnant the same month and now have a beautiful twin of 5 years old. since then i underwent 3 vaporization surgeries just to release my endo pains. now i'm 33 and want another baby. however i have no power to go over the whole ivf process once again and was looking if i go through another vaporization will i be able to conceive naturally? i hope to get an answer. for all those who are with endo and ttc it's a long journey but ivf is your only choice.

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Bella Aug 13, 2013 05:42:51 PM ET

Hi my name is bella i was diagnosed with endo about 2 yrs ago n had one sergery! i have two kids but my husband and i want another one. hopefully we get pregnant soon we been trying for 5 months now and nothing!

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Melissa Apr 15, 2013 03:21:27 AM ET

I had severe endometriosis removed by laparoscopy nov 2011 and had mirena put in at the same time. that mirena was the best thing ever! had it taken out 2 months ago and ttc baby number 1. i'm 33 and worried about how long it's going to take. my gyn is only giving us a 3 month trial of conceiving naturally before they intervene. anyone had luck falling pregnant quickly?

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