Every woman, sooner or later, thinks about the issues of motherhood. One of the obstacles that can stand in its way is endometriosis. This is a pathological condition characterized by abnormal growth of the endometrium. The risk of violation is a high probability of infertility.
What is endometriosis?
The endometrium lines the inner surface of the uterus. Its growth is affected by the hormone estradiol. Endometrium includes 2 layers – functional and basal. The functional layer is rejected along with the menstrual blood if conception did not occur.
In the first half of the cycle, the thickness of the endometrium increases in size. By the time of conception, it reaches the desired value. This is necessary so that the embryo can easily attach to the uterus. The process of implantation is influenced by such factors as:
- endometrial structure;
- blood circulation quality;
- layer thickness;
- lumen of arteries.
Endometriosis is characterized by the pathological condition of the endometrium. In medicine, there are 2 types of the disease – external and internal endometriosis. The outer one is characterized by the proliferation of endometrial tissue outside the uterus. This group includes retrocervical endometriosis, extragenital and genital.
For endometriosis is characterized by excessive thickness of the endometrial layers in the uterus. The disease is diagnosed hard. Very often, women learn about it only during pregnancy planning.
The causes of pathology include:
- long-term use of intrauterine contraceptives;
- genetic predisposition;
- hormonal abnormalities;
- impaired implantation of a fertilized egg;
- endocrine disruption;
- endometriosis after missed abortion;
- inflammatory diseases of the pelvic organs;
- abuse of physical activity during menstruation;
- diagnostic curettage of the uterus or abortion.
Diagnosis of the disease is possible in the process of laparoscopy or ultrasound. The severity of symptoms depends on the severity of the disease.
In the presence of endometriosis, the woman notes the following symptoms:
- severe pain during critical days;
- discomfort in the pelvic area during stool and urination;
- the presence of bloody intermenstrual discharge;
- pain during sexual intercourse;
- the presence of blood in the urine;
- lack of ovulation.
The final diagnosis is made only after the diagnostic operation – laparoscopy. It is not always possible to see the disease within an ultrasound scan.
Is it possible to conceive
Pregnancy with endometriosis of the uterus is possible only after treatment. The embryo attaches to the uterus at a thickness of the endometrium of 10 to 16 millimeters. With artificial insemination – not less than 8 millimeters.
There are 4 degrees of the disease. Each of them is characterized by a number of signs. Infertility can be prevented early in the disease.
Characteristics of the degrees of endometriosis:
- In the first stage of the disease, the woman does not notice significant changes. The only sign is an increase in the amount of menstrual flow. Diagnosis at this stage is difficult. If endometriosis is suspected, a histological examination is prescribed. Endometriosis grade 1 and pregnancy compatible. The disease does not have a strong impact on reproduction.
- The second degree of the disease appears brighter. Endometrial tissues firmly rooted in their places and increase in size. This condition is treated with hormonal drugs. Sometimes surgery is used. Endometriosis grade 2 and pregnancy can coexist, subject to the recommendations of the doctor.
Often the question arises whether endometriosis and pregnancy can be confused. This is possible with insufficient medical qualifications and deviations in the operation of the ultrasound machine. Especially high probability of error in early pregnancy. To avoid unpleasant situations, doctors recommend conducting a pregnancy test for any deviation in the reproductive system.
The course of ovarian endometriosis and pregnancy is quite possible. Sometimes foci of disease are localized in only one ovary. The second continues to function. Pathology does not greatly affect pregnancy. The exception is when the endometrial layer is too thin.
Features of pregnancy with endometriosis
Pregnancy after endometriosis is possible, but the presence of this disease increases the likelihood of miscarriage.
The features of this pregnancy include:
- probability of spontaneous abortion in the early stages;
- placental insufficiency;
- low embryo attachment;
- risk of placental abruption ahead of time;
- premature labor.
Conception occurs not immediately, but after prolonged treatment. Pregnancy with endometriosis is problematic, as there are difficulties in carrying a child. The reproductive system of a woman who has had endometriosis becomes vulnerable.
The main rule for those who want to maintain a pregnancy with endometriosis is to follow the recommendations of the gynecologist. He will select the optimal treatment regimen, focusing on the manifestation of the disease.
To save pregnancy with endometriosis prescribe:
- Utrozhestan – A drug that contains natural progesterone and regulates its level in a woman’s body. Used in pill and vaginal suppositories format. Contraindications: hypersensitivity to the components, thrombosis, vaginal bleeding, incomplete abortion, porphyria, severe liver disease, tumors of the mammary glands and genitals. Side effects: menstrual disorders, headache, bloating, itching, drowsiness.
Duphaston – Includes artificial progesterone. The drug affects the reproductive system in the same way as Utrozhestan. It is administered orally; it is not intended for vaginal administration. Contraindications: severe liver disease, Dubin-Johnson syndrome, Rotor syndrome, sensitivity to didrogesteron. Side effects: nausea, diarrhea, constipation, discomfort in the mammary glands, headache, itching.
Endometriosis and pregnancy after 40 years is a rather complicated combination. Besides the fact that the body is exhausted by the disease, there are age problems. Doctors in this case pay special attention to the patient. The dosage of drugs is increasing. In the early stages of pregnancy it is possible to be hospitalized.
It is much more difficult to get rid of chronic endometriosis, so it is very important not to start the disease. There are several ways to treat endometriosis:
- laparoscopic surgery;
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Most often, pregnancy occurs after laparoscopy of endometriosis. The operation is considered diagnostic. It is performed under general anesthesia. In the abdominal cavity make 3 holes – in the ovaries and in the navel. A special instrument is placed in these holes, with which the doctor determines the local location of the endometriotic focus. Excess tissue is removed. If there are spikes, they are dissected.
Planning pregnancy after surgery is not prohibited. The recovery period is short. After only 3-5 days, the woman fully returns to her normal life. The operation is a good way to stimulate the activity of the ovaries. In the absence of the male factor of infertility, the probability of a successful pregnancy increases significantly.
Endometriosis and pregnancy planning combine undesirable. It is recommended to completely get rid of the disease before conception. In order to prevent pregnancy during the period of treatment, oral contraceptives are prescribed. They inhibit ovarian function. Against this background, the likelihood of new foci of endometriosis is reduced. The course of treatment with oral contraceptives ranges from 3 to 6 months. When canceling the pill, a rebound effect occurs. The ovaries begin active work. Side effects of such treatment include multiple pregnancies.
To eliminate endometriosis, anti-inflammatory and vitamin therapy is also prescribed. This is necessary to soften the adhesions, which often occur when endometriosis is external. Endometriosis both in pregnancy and in its absence requires an integrated approach. Hormonal support is required. When planning, it affects the regularity of the menstrual cycle. In early pregnancy, endometriosis and its manifestations are muffled by progesterone.
Physiotherapy – an additional method of complex therapy. Regular procedures reduce pain in the pelvis, soften adhesions and improve blood circulation. This has a beneficial effect on the growth of the endometrium. The following procedures are distinguished:
- magnetic therapy;
- exposure to current;
- laser radiation;