Does endometriosis affect pregnancy?

Endometriosis is a common gynecological disease. This disease can cause a series of uncomfortable symptoms such as dysmenorrhea in women with the disease. Many women of childbearing age have questions in their minds: Does endometriosis affect pregnancy?

1. What is endometriosis?

Endometriosis is a gynecological disease in which the endometrium, which has growth function, grows outside the lining of the uterine cavity.

2. Does endometriosis affect pregnancy?

According to statistics, the infertility rate among women with endometriosis can reach 50%, and the risk of infertility among women with endometriosis is almost 20 times that of women without endometriosis. In addition, some women with unexplained infertility may have undiagnosed endometriosis.

Endometriosis can affect pregnancy from ovulation, fertilization, and implantation of the fertilized egg. Therefore, one of the clinical manifestations of endometriosis is infertility.

Ovulation stage: In some patients, luteinization occurs when the follicles mature and prepare for ovulation, but in the end the follicles are not discharged. However, in terms of basal body temperature testing and ovulation test strip testing, they are the same as normal ovulation. The hormone secretion of the ovaries is the same as normal ovulation. Ultrasound scans revealed that the ovaries were gradually maturing, but atrophy and luteinization occurred in situ.

Egg transport link: Some patients with endometriosis will develop pelvic adhesions, fallopian tube adhesions or even obstruction. The fallopian tubes are not functioning properly and cannot transport sperm to the designated location to meet the egg.

Fertilization stage: Patients with endometriosis, especially those with dysmenorrhea, have a relatively poor internal environment in the abdominal cavity and the presence of a large number of inflammatory factors, which are harmful to sperm and fertilized eggs and will devour sperm and fertilized eggs.

Implantation link: There is a theory called endometrium determinism. The reason why a person gets endometriosis is mainly because there is something wrong with the endometrium itself. Abnormal endometrium will affect the implantation of the fertilized egg.

3. Clinical manifestations of endometriosis

① Lower abdominal pain and dysmenorrhea: Pain is the main manifestation of this disease, and secondary dysmenorrhea and progressive worsening are typical symptoms. The pain is mostly located in the lower abdomen and lumbar spine, and sometimes radiates to the perineum, anus and thighs. It often occurs during irregular menstruation and lasts throughout the menstrual period. A small number of patients experience long-term lower abdominal pain, which worsens during menstruation, while 27% to 40% of patients do not have dysmenorrhea.

② Infertility: About 50% of patients experience infertility.

③ Menstrual abnormalities: 15%~30% of patients experience increased menstrual flow, prolonged menstrual period or prolonged menstruation.

④ Discomfort during sexual intercourse: generally manifested as deep pain during sexual intercourse, which is most obvious before menstruation.

⑤ Other special symptoms: Due to different sites of endometrial invasion, periodic bleeding after defecation, frequent urination, dysuria, hematuria, hemoptysis, nosebleed, etc. may occur; some patients may also have symptoms of low-grade fever during menstruation.

The treatment of endometriosis requires a combination of disease differentiation and syndrome differentiation, with blood circulation and blood stasis removal throughout the process, while syndrome differentiation and treatment should be carried out based on individual differences. Liver depression and qi stagnation are often accompanied by depression, gloomy mood, sentimentality, and poor emotions. The treatment principle is to regulate qi and activate blood circulation, dissipate nodules and relieve pain; those with cold and dampness stagnation are often accompanied by cold pain in the lower abdomen, dull pain, relieved by heat, aggravated abdominal pain during menstruation, fear of cold and cold limbs. The treatment principle is to warm the meridians and dredge the collaterals, activate blood circulation and remove blood stasis; those with kidney deficiency and blood stasis are often accompanied by low back pain, dizziness and tinnitus. The treatment principle is to activate blood circulation and remove blood stasis, tonify the kidney and regulate menstruation; those with internal resistance of blood stasis and heat often have low fever or fever during menstruation, dry stool, thirst or dry mouth without desire to drink. The treatment principle is to activate blood circulation and remove blood stasis, clear away heat and relieve nodules; those with phlegm and heat are often accompanied by obesity, drowsiness and fatigue, frequent vaginal discharge, white or thick greasy tongue coating. The treatment principle is to soften hard masses, remove blood stasis, activate blood circulation and relieve pain.

Although endometriosis is not a serious disease, it should be taken seriously by women who are preparing to have children. If you experience progressively worsening dysmenorrhea, heavy menstruation, pain during sexual intercourse, and other symptoms, you should go to the hospital for a check-up in time to determine whether it is endometriosis. It is recommended that women with endometriosis should receive treatment before becoming pregnant.