Table of contents
If you have been diagnosed with endometriosis and you want to become a mother, chances are you have asked yourself which the best way to achieve your goal is. There is no single answer to this question because each woman is unique and so is her endometriosis problem.
This is a disease that affects a significant percentage of women worldwide, with a prevalence of between 10% and 15% in countries such as the UK and throughout the European Union, equivalent to approximately 1.5 million women in the UK and 15 million in Europe.
Globally, an estimated 170 million women of reproductive age suffer from this condition. However, despite its high prevalence, endometriosis is still a significantly underdiagnosed disease, with an average delay in diagnosis of 7 to 8 years. This delay highlights the pressing need to raise awareness and develop better diagnostic strategies, as endometriosis has a significant impact on the quality of life of affected women.
In addition to its effect on health, endometriosis can also have a direct impact on fertility. Approximately 30% to 50% of women with endometriosis may experience difficulties in conceiving. In fact, around 40% of women with this disease face fertility-related problems. And, we have observed that endometriosis might be the cause of infertility in 25% of cases. This underlines the importance of early diagnosis and effective strategies to help patients deal with fertility challenges.
Next, we will explain how a personalised assisted reproduction treatment should be, taking into account the severity of the endometriosis, the hormonal situation, and also the personal preferences of each patient.
Causes of infertility due to endometriosis.
Endometriosis is a benign disease with no definitive treatment at present. It is characterised by the growth of endometrial tissue outside the uterus, causing inflammation, pain and abnormal bleeding, and thus complicating the viability of pregnancy. Endometriosis symptoms vary from woman to woman, depending on the location and extent of the lesions, as well as the individual’s response to medical treatments. The aim of these treatments is to relieve the symptoms and control the growth of endometrial tissue. This can be achieved through pharmacological, hormonal or natural therapy, or even surgery.
But what happens when a woman with endometriosis wants to become a mother? Well, it depends. Patients diagnosed with endometriosis have more difficulty conceiving naturally.
How does endometriosis affect fertility? Basically, in two main ways:
1-Anatomical problems. When the growth of endometrial tissue outside the uterus affects the ovaries, this can have an impact on oocyte quality. Patients who have undergone surgery on the ovary due to the presence of endometrioma may have compromised ovarian reserve.
And if endometriosis occurs in the fallopian tubes, these may have an irregular anatomy and the tubes may even be obstructed, making it impossible for the sperm to pass through and for the egg to be transported through the tube; consequently, the egg cannot be fertilised nor can it reach the uterus.
2-Alteration in endometrial receptivity due to the presence of adenomyosis foci in the thickness of the myometrium, hindering embryo implantation.
Assisted reproduction and endometriosis, what to consider?
If, despite the various medical and surgical treatments available to control the disease, you cannot get pregnant, then you might need to consider assisted reproduction treatments. Nonetheless, before deciding which treatment is the most appropriate, there are multiple factors to consider in each case:
● Severity of the disease: Endometriosis is a condition that varies in severity, from mild to severe. In milder cases, less invasive options can be explored, while more severe cases may require surgery.
● Age of the patient: Ovarian reserve decreases with age, which can influence the choice of treatment. In patients diagnosed with endometriosis, the most appropriate treatment is IVF.
● Hormonal status: Hormone levels can affect ovarian quality and the response to certain treatments. Therefore, a detailed diagnosis is essential to determine the most appropriate therapeutic approach.
● Personal preferences: Each woman has different circumstances and needs. Some may choose to preserve their fertility by vitrifying eggs before undergoing medical treatments, while others prefer to avoid surgery and try hormonal alternatives.
● Medical history: Previous surgeries, previous hormonal treatments, autoimmune diseases or any other medical condition can influence the choice of assisted reproduction treatment. Specialists have to take all these issues into account in order to individualise the options that maximise the chances of success while minimising risks.
Personalised assisted reproduction treatment
Once we have studied each case, and depending on all the relevant factors, especially the severity of the endometriosis and the progress of the treatments, different reproduction treatment options are available:
Artificial Insemination (AI) is not recommended for patients diagnosed with endometriosis due to its low pregnancy rate.
In vitro fertilisation (IVF): This is the treatment of choice for patients diagnosed with endometriosis, regardless of the degree of endometriosis involvement, as the egg quality in these patients tends to be compromised
Egg donation: As it has been proven that both the eggs and the embryos of patients with endometriosis have a poorer morphology, IVF with egg donation can be another treatment option in cases where previous treatments have failed. This is also an option for women whose endometriosis is so severe that endometrial tissue is affecting the ovaries, making it impossible to retrieve eggs for IVF, or when the patient’s ovarian reserve or age require it.
Preservation of fertility: For women diagnosed at an early age and/or with a high risk of disease progression, egg vitrification may be a recommended strategy to enable them to become mothers with their own eggs in the future.
Advances in endometriosis treatment
Today, endometriosis is still a chronic disease, with relapses and no definitive treatment. Research is being carried out into early diagnosis through genetic studies, and there are also new therapeutic approaches, such as more specific drugs and less invasive surgical techniques, which are improving the patients’ quality of life and increasing the chances of success in fertility treatments.
At Tambre, we are committed to innovation, and as a result, we use the latest advances in assisted reproduction, enabling us to offer personalised and effective solutions.
Emotional care for comprehensive treatment
At Tambre, our patients not only receive personalised treatment, but also benefit from a team of staff committed to their overall well-being. Under these circumstances, feeling overwhelmed, frustrated or even hopeless is normal, so it is essential to rely on a solid support system and effective strategies to help you cope with the ups and downs of the process.
That is why, at Tambre, we have a Psychology Unit, which helps manage stressful situations and changing emotions, using strategies that strengthen the mental health of the woman, as well as her partner.
Since we are aware that embarking on a fertility treatment raises thousands of questions, at Tambre we also have a Support or Care Team that will look after you from your first visit onwards. Your personal assistant will be the person in charge of looking after you, answering your questions, introducing you to your medical team and accompanying you throughout the process so that you never feel disoriented during your tests and treatment at Tambre.
We believe that, with the right medical, technical and human approach and personalised treatments, we can tackle endometriosis and bring you closer to your dream of becoming a mother. If you would like more information about our treatment options for endometriosis and fertility, do not hesitate to contact us on (+34) 91 411 61 11 and request your first appointment at Tambre
