- Preterm birth
- Cesarean delivery
- Ectopic pregnancy
- Placenta previa
- Antepartum and postpartum hemorrhage
How can you increase fertility if you have endometriosis?
In most cases, a combination of both medical and surgical procedures is required to improve symptoms and increase fertility.
Women with a Stage I or II endometriosis have an option to proceed with natural conception, but they can also benefit from ovulation induction, intrauterine insemination (IUI), and Assisted Reproductive Technology (ART).
While ART has been found to be more effective compared to other methods, it is costly and might not always be accessible to the patient. Ovulation induction and IUI, on the other hand, are less expensive, but can result in the delay of conception if ineffective.
The choice of treatment for infertility among women with endometriosis is based on clinical indications, the patient’s age and preference, and procedure risk.
The following are the current recommendations for women with endometriosis who want to get pregnant:
- For females younger than 35 years who want to try natural conception, six months of timed intercourse is advised. If unsuccessful after six months, ovulation induction with clomiphene citrate (CC) and IUI is recommended.
- Females younger than 35 years who prefer infertility treatment (rather than natural conception), or who do not conceive naturally may proceed with ovulation induction with CC or letrozole plus IUI.
- For women older than 35, the general recommendation is to proceed with ART. However, clomiphene may also be given if ART is not possible for any reason. ART has been shown to reduce the time to conception. Moreover, ART offers the option to freeze excess embryos for possible future use.
Endometriosis is a benign gynecologic condition that presents as pelvic pain, abnormal uterine bleeding, and dysmenorrhea. Women suffering from endometriosis may find it harder to conceive compared to those who are not. Fortunately, there are several medical and surgical procedures that can increase fertility despite having this condition.