While endometriosis is prevalent among women in their reproductive years, its effects on pregnancy have not been well studied. Some women with endometriosis find that their symptoms subside during pregnancy, but others notice no difference. The risk of certain pregnancy-related complications may be higher for women who have endometriosis, and especially for those who have been treated for infertility. Because pregnant women who have endometriosis are considered to be high risk, their healthcare providers should closely follow the progress of their pregnancies.
What Is Endometriosis?
Endometriosis is a common condition that affects about 15 percent of women during their childbearing years. During a woman’s monthly menstrual cycle, endometrial tissue builds up inside the uterus. If a pregnancy does not occur, this tissue breaks down and is expelled from the body during menstruation. In women who have endometriosis, endometrial tissue begins to grow outside the uterus. Often the endometrial tissue is in the abdominal area, but it can also appear in other areas of the body, though this is not common. This tissue cannot break down and exit the body through the vagina, as it does when it is located in the uterus. The growing tissue may not cause any symptoms, but in some cases it can cause:
- Heavy, painful periods
- Painful intercourse
- Urinary or digestive problems
Endometriosis is also commonly associated with infertility, and approximately 50 percent of women with endometriosis experience this complication. Women with infertility due to endometriosis may seek fertility treatments in order to get pregnant. Fertility treatments, especially in-vitro fertilization, are associated with a low risk of certain complications for the mother and the fetus, such as birth defects or preterm labor. Endometriosis also carries risks for the mother and the baby during pregnancy.
Is Pregnancy A Treatment For Endometriosis?
Pregnancy is an important life choice that deserves careful consideration before it is undertaken. It is thought that the hormones produced during pregnancy may have a positive effect on the symptoms of endometriosis. This effect may continue after delivery and while breastfeeding. This is not because the endometriosis has been cured, however; the symptoms have merely subsided.
Some women may also find that the symptoms of endometriosis actually recur during a pregnancy. In many cases, regardless of whether the symptoms have subsided during pregnancy, they will return at some point after the baby is delivered.
How Does Pregnancy Affect Endometriosis?
It’s important to remember that pregnancy will not cure endometriosis. It was once thought that pregnancy was an effective treatment because symptoms subsided while pregnant and for some time after delivery. It’s now known that while symptoms may abate during this time, pregnancy is not truly a long-term treatment for endometriosis.
Endometriosis And Infertility
The effect of endometriosis on a woman’s fertility is well documented. Many women with endometriosis experience infertility, and many decide to undergo assisted reproduction procedures, including intrauterine insemination and in-vitro fertilization. These procedures can result in a healthy pregnancy and baby, but in some cases they carry a risk to the mother and the fetus.
What Are The Potential Complications?
There has not been much study of the complications that may occur in pregnant women with endometriosis. There have been some preliminary studies, however, showing that endometriosis can predispose some pregnant women and their babies to certain poor pregnancy outcomes. Pregnant women who have endometriosis are often considered to be high-risk. The potential complications for women with endometriosis can include:
Preterm birth: One study showed that women with endometriosis are at greater risk of delivering their babies early, compared with women who did not have endometriosis.
Caesarean delivery: Women with endometriosis may be more likely to require delivery by Caesarean section.
Pre-eclampsia: This condition is characterized by high blood pressure and affects pregnant women in their second and third trimesters.
Antepartum hemorrhage: Antepartum hemorrhage is bleeding during the second half of pregnancy. This potential complication of pregnancy could be caused by placental abruption or placenta previa, but in many cases, the cause of bleeding is unknown. Placental abruption is when the placenta separates from the uterus, and is a major cause of pregnancy loss. In placenta previa, the placenta is actually blocking the cervix, which could lead to significant bleeding.
Miscarriage: Some studies have shown that endometriosis is associated with spontaneous abortion, but others have found no association. A miscarriage is defined as the loss of a pregnancy before 20 weeks.
Stillbirth: Stillbirth is the loss of a pregnancy after 20 weeks. It is not known conclusively whether stillbirth is associated with endometriosis, but some studies have shown a connection. In many cases, the cause of stillbirth is not known.
The Prognosis For Pregnancy And Endometriosis
While endometriosis seems to be associated with complications during pregnancy, these effects have not been well studied. While the symptoms of endometriosis may be lessened or nonexistent during pregnancy and thereafter, pregnancy does not treat the underlying problem. Pregnant women who have endometriosis are considered to be high risk, and should be monitored closely by their physicians.