Everyone's experience of having a baby is different but understanding your own fertility is the best thing you can do. It is also important to understand that while current evidence suggests that women with endometriosis are more likely to experience fertility problems, not all women will endometriosis will need assistance. Below we share the possible impacts of endometriosis on fertility and treatments available for those needing help.
Understanding your fertility
Your fertility can be affected by a number of factors: age, weight, and general health alongside conditions such as endometriosis and PCOS.
Age is the most important factor. The chance of pregnancy falls as a woman gets older, and the risk of miscarriage and abnormalities increases, even for people with no fertility problems. If you are having trouble becoming pregnant, the sooner you seek help, the better your chance of having a baby.
Impacts of Endometriosis on Fertility
Endometriosis may affect fertility in a number of ways such as:
The impact of adhesions on fallopian tubes or ovaries.
Inflammation impairing the function of both eggs and sperm, fertilisation, embryo development, and implantation
Ovarian follicles not developing, rupturing, or releasing the eggs well due to inflammation in and around the ovaries
Endometrioma (ovarian cysts) stopping the tube from picking up the egg
Pain impacting on the desire for sex
Treatments for those with endometriosis and fertility problems
Fertility treatments that can assist women with endometriosis include Intrauterine insemination with stimulation (IUIS) and In-vitro fertilisation (IVF).
IUIS is generally, a good option for young women. Intra Uterine Insemination involves preparing sperm in the lab, then putting the best sperm directly into the uterus in a procedure that’s a bit like having a cervical smear.
IUIS cycles typically involve some blood tests, 1-2 ultrasound scans and injections, which people usually give themselves at home.
IUI is usually offered as a course of up to 4 cycles. Around 40–50% of women aged 37 and younger have a child within 4 cycles, and the main ‘side effect’ is a 10-15% chance of twins.
IVF is a highly effective treatment with the chance of a baby dependent on a woman’s age and Ovarian Reserve (the number of eggs a woman has in her ovaries). For women 35+ IVF generally offers the best chance of a baby.
IVF treatment creates the optimal conditions required to give eggs and sperm the highest chance of getting together to create a pregnancy.
When to seek help
Medical advice is that if you have been trying to conceive for 12 months or more to seek help from your GP. However, if you are aged 35+ seek help after trying for 6-9 months and if you are aged 40+ see your GP after 6 months of trying to conceive.
It is also recommended that you seek advice from a fertility specialist if you have endometriosis, polycystic ovaries, or PCOS or have been through a cancer diagnosis.
As well as being able to access fertility treatments privately, there is public funding available for both consultations with fertility specialists and / or fertility treatment.
There are criteria that must be met for each, and there are some variations in both criteria and wait times between District Health Boards. Criteria is complex and you can find further details regarding public funding at: https://www.fertilitynz.org.nz/information/fertility-treatment-options/public-funding-fertility-treatment/
Coping with fertility problems
Problems conceiving may involve a series of losses - loss of hopes and dreams, loss of control, loss of a positive self-image, loss of privacy, loss of feeling connected, belonging, and many more. These losses may be invisible to others. Those experiencing fertility problems may feel lonely and isolated from friends and family, and sometimes from their partner. Uncertain outcomes, and coping with fertility treatments can compound these issues.
Some social gatherings might be hard to cope with. While some conversations may be difficult or painful, with some preparation they may also be an opportunity to explain your situation to friends and seek support. Aim to be open and assertive rather than defensive. Remember that just because a question is asked does not mean you have to answer it.
Below are some coping strategies if you are experiencing infertility:
Seek information from fertility specialists, counsellors or Fertility NZ and inform yourself about the options available to you.
Join a local support group: sharing experiences can be helpful and help you to feel less isolated.
Look after yourself: self-care can help minimise the negative impact that fertility problems can have on your mind, body and soul.
Research shows that writing or drawing about painful experiences is therapeutic and can be a form of release during tense and stressful times.
Some people start to feel better in weeks or months, while for others it may take much longer. Whatever your grief experience is, it is important to be patient with yourself, take time to grieve, and seek help if you sense the need.
It’s especially important that you talk to your doctor or a counsellor if you:
are unable to perform your normal daily activities over an extended period
feel life isn’t worth living
are having difficulty trusting others since your loss.