I have endometriosis. What can happen to me? (II)

Endometriosis is a benign disease that affects many patients during their reproductive life. We want to help you to better understand it. Next we continue answering to some of the questions that are more frequently asked by patients:

. Can endometriosis be cured?

Unfortunately nowadays there’s no cure to solve this problem. Surgery may relief the pain by removing the areas affected, but no one can guarantee that the lesions don’t appear again.

. Is there any effective treatment?

There is, if you want to improve the quality of life of the patient by relieving the pain, delay the progression of the disease o preserve the ovarian function. Unfortunately no treatment has proven to be useful in regards to improve the fertility of the patients.

If surgery is needed it’s mandatory to minimize the impact on the ovary by removing only the affected tissue thus preserving the máximum number of follicles.

Sometimes medical treatment can make the surgery easier by reducing the number of lesions, and in cases where the symptoms are really invalidating it might be the first option if the patient is close to the menopause.

. Must I undergo a surgery?

When surgery is needed healthy ovarian tissue may be removed along with the cyst. Also the coagulation of the bleeding surfaces that surround the cyst may destroy follicles. This may lead to a diminished ovarian reserve, especially when more than one surgery is carried out. This is why the current trend is to keep the surgery as the last option (basically in cases of big cysts or when the symptoms are really invalidating and the medical treatments have been helpless) and try to be as conservative as possible during the procedure.

. Is endometriosis contagious?

No, the endometriosis is not an infectious disease and can not be transmitted when having intercourse

. Is endometriosis a hereditary disease?

A recently published study coordinated by the Oxford University has shown that patients carrying abnormalities in the locus 7p15.2 may have an increased risk of having endometriosis. It has also been identified an enzyme, called telomerasa, that is seemingly related to the onset and development of endometriosis.

. Can endometriosis increase the risk of cancer?

The endometriosis is a benign disease and though in some cases it can really worsen the quality of life, it cannot cause cancer.

. Why endometriosis can cause infertility?

Endometriosis may lead to infertiilty through different mechanisms:

   –  destroying the ovarian tissue due to the local inflammation it causes

   –  causing adhesions that can damage the tubes occluding them

   –  producing substances that can be toxic for the oocyte

 . What is going to happen when I decide to get pregnant if I have endometriosis?

20% of the patients that have endometriosis will be infertile. Our current recommendation because of this risk is that a patient with endometriosis may try to conceive naturally for 6 months. If no pregnancy takes place, please go to see your doctor.

. Which is the best treatment to get pregnant if I have endometriosis?

In cases of infertility IVF is the best option, but each case should be assessed individually. If the tubes are patent trying 3 IUI before undergoing an IVF can be an option, though the pregnancy rates in these cases are lower compared to IUI due to other infertility causes (may be because of the toxins that can affect the oocyte quality).

. How can endometriosis affect a fertility treatment?

The studies have demonstrated that because of the reduction of the ovarian health tissue the number of oocytes that these patients produce is lower than the average for the same age and stimulation protocol. But the quality of the eggs retrieved, the fertilizations rates, the embryos qualities and the implantation rates are those expected in other causes of infertility, like tubal occlusion.

Some groups describe an increased risk of miscarriage in these patients that we have not been able to corroborate.

. Is it true that a pregnancy may cure endometriosis?

The pregnancy has a protective effect against this disease because the ovaries are resting and don’t produce the hormones that stimulate the development of the disease.

  

  

One Comment

Rhod Minster

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