According to the World Health Organization (WHO), endometriosis affects approximately 10% of women of reproductive age worldwide.
Among the side effects experienced by endometriosis sufferers, Fertility problems stand out as one of the most painful symptoms.
However, equipped with accurate information on how to manage symptoms as well as available treatment options, Women can reduce the impact that the disease has on their lives and on their dreams of having a family.
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Awareness
That’s the message of hope gynecologist Dr Abri de Bruin wants to share with South Africans as the world watches International Endometriosis Awareness Month.
Dr de Bruyn is the Senior Medical Director of the Genesis Reproductive Center and heads Mediclinic Kloof’s dedicated multidisciplinary endometriosis unit, which currently has the most modern theater in the southern hemisphere.
In his opinion, awareness campaigns highlighting the prevalence of endometriosis and the importance of reproductive health are vital to curbing the effects of this “21St disease of the century”.
“Endometriosis is definitely more prevalent today than it was 20 years ago, and it’s becoming more prevalent in younger women,” she elaborates. Dr. de Bruyn. “Experts attribute this increase to factors such as increased stress levels as well as the types of hormones contained in the foods we eat.”
Furthermore, studies have shown that in South Africa – and in Africa in general – the prevalence of endometriosis has been greatly underestimated, due to high diagnostic costs, lack of information and underdeveloped health care infrastructure.
“While the medical community has yet to pinpoint the exact reason why endometriosis develops in some people, we now have infinitely more knowledge about how it occurs in different women and how to treat it in the least invasive way.”
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Endometriosis and the causes of fertility problems
Endometriosis is a condition where the cells that form the lining of the uterus grow outside the uterus.
Symptoms of endometriosis vary from person to person, but usually result in:
- Painful periods?
- Chronic pelvic pain? and
- Pain during intercourse.
In many cases, the effect of the disease on reproductive health is often the most pronounced, since issues such as infertilitydifficulty conceiving and the impact on one’s quality of life can be emotionally and mentally devastating.
According to Dr. de Bruin, endometriosis can cause infertility if it results in adhesions (scar tissue) that cause the ovaries and fallopian tubes to stick together or the ovaries to stick to the side wall of the pelvis. This prevents fertilization.
In cases where endometriosis occurs within an ovary, it can prevent or reduce the chances of ovulation or egg production, which in turn makes conception more difficult.
In addition, if endometriosis develops inside the uterus and penetrates the uterine wall, this leads to a condition called adenomyosis, which adversely affects the implantation of the fetus in the uterus.
Finally, if endometriosis forms inside the pelvis, this it creates a hostile environment that reduces the quality of the egg that is formed. This, in turn, affects the function of the fallopian tube to receive the eggaffecting fertilization, embryo development and implantation.
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Effective treatment options
However, as Dr de Bruin argues: “Having endometriosis does not automatically mean that you cannot get pregnant or that you should have in vitro fertilization (IVF).
This is because Endometriosis occurs in four stages, ranging from minimal to severe. Each stage has a different impact on infertility, however even patients with stage four endometriosis can conceive without medical intervention. The encouraging news is that there are a number of treatments and strategies that can help endometriosis sufferers increase their chances of conceiving.”
Elaborating on this, Dr. de Bruin explains that treatment is tailored to patients based on whether they have pain only, infertility only, or both pain and infertility.
“This is a very important distinction to make. For example, if a patient has no symptoms other than infertility and endometriosis is found via ultrasound, then fertility treatment can be started without surgery.
However, if a patient presents with both infertility and pain, then we need to do surgery to treat the endometriosis. This is because even if a patient is able to conceive, her quality of life can be reduced by the disease. And if he cannot conceive, Surgery to remove endometriosis can increase her chances of getting pregnant,” He says.
Explaining how to treat infertility surgically, Dr. de Bruin says that no open surgery is ever indicated for endometriosis. Instead, the procedure is laparoscopic. or minimally invasive, and resection, which involves removing the diseased tissue from the body.
For example, if a patient’s endometriosis is causing adhesions, surgery can remove that tissue to restore a normal relationship between the fallopian tube and ovary, which increases the chance of getting pregnant. Likewise, if the endometrium is removed from inside the ovary, it will no longer have an impact on egg quality. In addition, removing endometriosis in the pelvis also removes the hostile environment it creates.
Based on his experience, Dr de Bruin concludes with these encouraging statistics. “Even in patients with stage four endometriosis, the chance of getting pregnant is greater than 60% either after surgery, IVF or a combination of the two.
Author: Pedro van Gaalen
When he’s not writing about sports or health and fitness, Pedro is most likely out training for his next marathon or ultramarathon. He has worked as a fitness professional and as a marketing and comms specialist. He now combines his passions in his role as managing editor at Fitness magazine.
