It’s estimated that 1 in 10 women will be diagnosed with endometriosis in their lifetime. Furthermore, they’re likely to develop the condition between the ages of 25 and 40, which doctors often call their ‘childbearing years’. Since endometriosis can affect fertility, it’s important to know your options for having children.
When you have endometriosis, the tissue that should only be in the uterus grows elsewhere in the body. If this abnormal tissue grows around the ovaries or fallopian tubes, you can get scarring and inflammation that causes infertility.
Additionally, endometriosis has been shown to affect the quality of eggs and the environment in which they develop. These factors can make it more difficult to get pregnant and studies show that up to 50 percent of those with endometriosis also deal with infertility. In fact, your odds of conceiving naturally when you have the condition can be as low as one percent.
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This option is typically reserved for the first stage of endometriosis where there are only a few small areas of abnormal tissue and no evidence of scar tissue.
Depending on the location of the abnormal tissue, your doctor may suggest laparoscopic surgery to remove it. Doing this can increase your odds of conceiving naturally. However, if you don’t get pregnant within six months, your doctor is likely to recommend moving on to other options.
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IUI is the route that most doctors recommend for people who have the first and second stages of endometriosis. In stage 2 of the condition, you have more areas of abnormal tissue but there’s still no scarring. Again, your doctor may suggest removing the tissue with surgery. In either case, IUI entails giving you the fertility drug clomiphene citrate five days after menstruation starts.
Once you’re ovulating, your partner will provide a sample of sperm to the laboratory. Your doctor will then place the processed sperm into your uterus using a thin tube.
IUI generally has a 10 percent success rate when you’re under 40 but you may have to try a few times. However, if you’re unsuccessful after three to six months, your doctor is likely to suggest IVF.
IVF is the last resort and it’s reserved for the later stages of endometriosis. In stages 3 and 4, you’re likely to have larger areas of abnormal tissue, moderate to significant scarring, and endometriotic cysts in your ovaries.
Your doctor may recommend surgery depending on how it would affect your odds of getting pregnant. When doing IVF, you’ll do several rounds of fertility drugs to spur the growth of multiple eggs. When they are mature, the eggs will be removed and fertilized in the laboratory. The fertilized eggs will then be implanted in your uterus. IVF has a higher level of success when you’re younger but there’s still a 10 percent chance of pregnancy in your 40s.
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If you’re a Black woman who thinks you might have endometriosis, it’s essential to let your doctor know that you want to have children. There are several reasons for this.
Firstly, statistics show that Black Americans tend to be diagnosed five to ten years later than other ethnicities. A late diagnosis can mean that the condition has progressed to a more serious stage.
Secondly, the numbers show that many doctors are more likely to recommend invasive surgery than other treatment options when it comes to Black women. If you want to have children, a hysterectomy is the last thing you’d be interested in so it’s good for your doctor to know.
Thirdly, even if you’re not thinking about children, you should know that Black women have a higher risk of complications after having invasive surgery. These complications can include infection, blood clots, bleeding, bladder damage, and ovary failure.
Some people have very few symptoms when living with endometriosis. However, others have to deal with health issues including infertility. If you’re wondering how the condition will affect you, it’s best to talk to your doctor as soon as possible so they can determine a plan for the way forward.
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