How Endometriosis Affects Pregnancy

Endometriosis complicates conception and pregnancy in many ways. If you conceive with this condition, have an ob-gyn monitor your health.

Publish 10 June 2021

Pregnancy is Complicated

In America, endometriosis affects more than 10% of the female population. Across the globe, greater than 175 million women are suffering from endometriosis. A woman with endometriosis can experience pain and difficulties with pregnancy. This requires ongoing medical care.

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When a woman with endometriosis gets pregnant, there are more complica­tions. In this regard, obstetrics and gynecology (ob-gyn) is invaluable. Let’s have a look at what endometriosis is and how it affects pregnancy.

Endometriosis

The endometrium that lines the uterine walls grows outside the uterus, causing pain. Endometrial cells can grow into the pelvis.

As the menstrual cycle begins, endometrial cells grow, shrink, and bleed. These endometrial cells gradually develop within ovaries (release eggs), fallopian tubes (transport egg to uterus), and the pelvis. Subsequent irritation of these organs makes it difficult for a woman to conceive a child. ^[1]

Some women do not observe any endometriosis symptoms. But most experience the following ^[2]:

• Frequent urination
• Constipation
• Irregular and painful periods
• Heavy menstrual bleeding
• Pelvic pain
• Painful copulation

How Endometriosis Affects Fertility

If a woman with endometriosis gets pregnant, it presents complications. In severe cases, the abnormal endometrial cells:

• Block the fallopian tube, thus affecting its function.
• Block the ovary, interfering with egg release.

According to research, the endometrial cells can cause severe inflammation during endometriosis. This inflammation severely affects estrogen and progesterone—important hormones during pregnancy. ^[3]

Effects of Endometriosis on Pregnancy

Normally, an ovary releases an egg that reaches the fallopian tube. When fertilized by a spermatozoon, it starts growing by attaching itself to uterine wall. During endometriosis, cyst-filled endometrial cells block the release of eggs.

These are ways endometriosis interferes with fertilization:

• Damage to the egg or sperm.
• Distortion of uterine cavity due to which, embryo does not implant.
• The immune system attacks the embryo.
• Inflammation influences the quality of eggs.
• Obstruction of fallopian tube. ^[4]

Endometriosis increases the chance of delivering premature babies. Sometimes, endometriosis improves during pregnancy. But it then causes complications during a future pregnancy.

Risks and Complications

• Miscarriage: Several studies report elevated miscarriage rates. One retrospective study found that women with endometriosis are more likely to experience miscarriage by 35.8 percent versus 22 percent in women without the condition. ^[5]
• Preterm Birth: A pregnant woman with endometriosis tends to give birth before 37 weeks of pregnancy by 1.7 times more than other expectant mothers. When an infant is born before 37 weeks of gestation, it is considered preterm. ^[6]

Prematurely born infants have a low birth weight and are more likely to encounter health and developmental issues. Preterm birth or early labor signs include:

• Periodic Contractions: Tightening of uterine muscles may cause midsection pain.
• Modification of Vaginal Discharge: Vaginal mucus viscosity can change or become bloody.
• Pelvis strain
• Placenta Previa: Your uterus produces placenta during pregnancy. This is the structure that supplies your developing fetus with oxygen and nourish­ment. Normally, it binds to the top of uterus. Placenta previa occurs when the placenta at the opening of the cervix binds to the bottom of the uterus.

Placenta previa increases risk of ruptured placenta during childbirth. A ruptured placenta can lead to serious bleeding, putting you and your baby at risk.

Endometriosis may elevate risk for placenta previa. Bright red vaginal bleeding is the major symptom. With minor bleeding, doctors may advise you to restrict your habits, including sex and exercise. You might receive a recommendation of blood transfusion and emergency C-section in cases of serious bleeding. ^[7]

Endometriosis Treatment

Doctors do not recommend that pregnant women receive the standard thera­pies for endo­me­trio­sis, which are surgery and hormone therapy.

Over-the-counter pain relievers can help decrease the discomfort of endo­me­trio­sis. Ask your ob-gyn doctor for a recommendation of how long you can use which ones safely. Hormone therapy and laparoscopic surgery is also useful. ^[8] Self-help steps include:

• Take hot baths.
• Consume foods high in fiber to reduce the chance of constipation.
• Walk slowly or practice prenatal yoga to alleviate back pain associated with endometriosis.

Receive an early diagnosis and treatment plan for endometriosis from your ob-gyn physician. This will help you better plan for pregnancy.