How Endometriosis Affects Conception by Dr. Mike Berkley

While the pregnancy rates for patients with endometriosis remain lower than those of the general population, most patients with endometriosis do not experience fertility problems. We do not have a clear understanding of the cause-effect relationship of endometriosis and infertility

What is the Cause of Endometriosis?

The cause of endometriosis is still unknown. One theory is that during menstruation some of the menstrual tissue backs up through the fallopian tubes into the abdomen, where it implants and grows. Another theory suggests that endometriosis may be a genetic process or that certain families may have predisposing factors to endometriosis. In the latter view, endometriosis is seen as the tissue development process gone awry.

According to the theory of traditional chinese medicine, endometriosis is a disease which is caused by the stagnation of blood. Blood stagnation may occur due to one or more abortions or lower abdominal or pelvic surgeries.

Additionally, engaging in sexual intercourse during menstruation may very likely over time cause blood stagnation. Emotional trauma, severe stress, physical or emotional abuse can all lead to the stagnation of blood.

Additionally, diet may be a precipitating factor. The constant, long term ingestion of cold foods can congeal blood and thus contribute to the stagnation thereof. Cold foods include raw vegetable, ices, ice cream, ice in drinks, frozen yogurt, etc. Remember, cold congeals. Think about what happens to a normal glass of water when put in the freezer. It turns to ice.

The blood is affected similarly. That is to say, it congeals, doesn't flow smoothly and can form endometrial adhesions, chocolate cysts, uterine fibroids. Whatever the cause of endometriosis, its progression is influenced by various stimulating factors such as hormones or growth factors. In this regard, investigators are studying the role of the immune system in activating cells that may secrete factors which, in turn, stimulate endometriosis.

In addition to these new hypotheses, investigators are continuing to look into previous theories that endometriosis is a disease influenced by delaying childbearing. Since the hormones made by the placenta during pregnancy prevent ovulation, the progress of endometriosis is slowed or stopped during pregnancy and the total number of lifetime cycles is reduced for a woman who had multiple pregnancies.

How is Endometriosis Diagnosed?

Diagnosis of endometriosis begins with a gynecologist evaluating the patient's medical history. A complete physical exam, including a pelvic examination, is also necessary. However, diagnosis of endometriosis is only complete when proven by a laparoscopy, a minor surgical procedure in which a laparoscope (a tube with a light in it) is inserted into a small incision in the abdomen.

The laparoscope is moved around the abdomen, which has been distended with carbon dioxide gas to make the organs easier to see. The surgeon can then check the condition of the abdominal organs and see the endometrial implants. The laparoscopy will show the locations, extent, and size of the growths and will help the patient and her doctor make better-informed decisions about treatment. Endometriosis is a long-standing disease that often develops slowly.

What is the Treatment?

While the treatment for endometriosis has varied over the years, doctors now agree that if the symptoms are mild, no further treatment other than medication for pain may be needed. Endometriosis is a progressive disorder.

It is my opinion that by not treating endometriosis it will get worse. Treatment should immediately after a positive diagnosis is made. The pain associated with endometriosis can be diminished by using acupuncture and herbal medicine. I have treated many women with endometriosis and have successfully alleviated pain and slowed down growth and recurrence of endometriosis.

For those patients with mild or minimal endometriosis who wish to become pregnant, doctors are advising that, depending on the age of the patient and the amount of pain associated with the disease, the best course of action is to have a trial period of unprotected intercourse for 6 months to 1 year. If pregnancy does not occur within that time, then further treatment may be needed. Again, these patients should consider herbal medicine to aid in the process of conception.

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BIO:

Dr. Mike Berkley is the founder and director of The Berkley Center for Reproductive Wellness, in New York. He works exclusively in the area of reproductive medicine and enjoys working in conjunction with some of New York’s most prestigious reproductive endocrinologists. Sign up for his free newsletter at www.BerkleyCenter.com

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