Irregular periods, problems getting pregnant… Is it endometriosis?

For many of us, endometriosis sounds like a death sentence. You dream of a child, you want to create a family, but your desires are shrouded in fear that you may never have a child. The complicated names of surgical procedures make you shudder. After years of trying, you are afraid to invest what little hope you have left, suspecting that failure could spell your end as the thin ice of strength to fight for your baby cracks.

Obstacles to fertilization can be solved by assisted reproduction techniques, i.e. IUI insemination, intracytoplasmic sperm injection ICSI, or in vitro fertilization IVI. The adopted form of treatment together with the severity of changes determines the success of the therapy. Efficiency ranges from 20-40%.

What exactly is endometriosis?

Endometriosis it concerns over one million Polish women. It can be diagnosed by laparoscopy and biopsy of biopsies, as the observed symptoms are not sufficient to confirm the disease. The foci of the uterine lining are widespread outside its cavity, but the tissue retains the functions of the endometrium, increases under the influence of estrogens, which is accompanied by an increase in symptoms. The foci cover the peritoneal cavity, ovaries and fallopian tubes. Adhesions limit the patency of the fallopian tubes or contribute to the retrograde transport of the ovum. This is associated with the risk of ectopic pregnancy, which almost never has a happy ending, and often puts the life of the would-be mother at risk. Autoimmune reactions are possible, which are associated with the formation of antibodies, habitual miscarriages and the inability to implant the embryo. The ovarian reserve under the influence of the cyst is constantly decreasing, and it is also difficult to maintain the regularity of menstruation and ovulation.

Difficulty getting pregnant, next to pain, is the most serious consequence of endometriosis. This disease is classified as one of the most common causes of female infertility. Regardless of whether we undergo treatment using medications or are directed to any of the treatments, the therapy is symptomatic and the disease does not lose its topicality.

3 techniques of assisted reproduction in practice

1. Laparoscopy involves the removal of adhesions and foci. Performed at I-II degree of severity of changes resulting from endometriosis, it doubles the probability of fertilization and remains at this level up to a year after the procedure.
2. Then it is proposed inseminationduring which the male sperm is introduced into the reproductive tract. Insemination can be intracervical, vaginal or intrauterine. Due to the obstruction of the fallopian tubes, there is a significant risk of failure. Before it is performed, at least one of them should be checked for patency by imaging, i.e. hysterosalpingography.
3. Stimulation of ovulation is necessary before in vitro. The retrieved egg is placed in a vessel that receives sperm from the sperm donated by the man. 1-2 embryos are transferred to the uterine cavity between 2 and 5 days after fertilization. Before the pregnancy test is done on day 10, the woman should take progesterone and dydrogesterone.

Complications

• Ovarian hyperstimulation syndrome – more than 1 egg follicle matures in a cycle, which is manifested by vomiting, abdominal pain, blood clots, and even kidney damage.
• Ectopic pregnancy.
• Heteroctopic pregnancy – one of the embryos develops outside the uterus and the other inside it.