Infertility and Endometriosis

Ive often wondered exactly how the mere presence of endometriosis can cause so many of us to have difficulty conceiving and carrying a pregnancy to term. Is it a direct cause and effect? Theories have been discussed and proposed, but so far, no one knows for certain. 

Maybe it happens on a biochemical or genetic level. Perhaps endometriosis affects egg quality and ovulation. Perhaps it creates a hostile and inflammatory environment for the sperm or embryos. Possibly it affects hormone levels during the luteal phase of our cycles. Or maybe it causes multiple changes in the way our reproductive organs function. Whatever this disease is doing to our reproductive health and the way its doing it, I know one thing for certain: infertility is very real and very painful for many of us.

I know because I went through it. Believe me, its not an easy thing to endure. First they tried medication. Followed by surgery. When that failed, fertility drugs and high-tech fertility procedures. When that didnt work, more surgery. Then a heart-wrenching miscarriage. Finally, after a near total depletion of physical, mental, and financial resources, it was time to stop pursuing infertility treatment and accept the cards Id been dealt.

Those were difficult times. But over the years, the longing and sorrow gradually departed and acceptance took their place. My childfree life though not what I envisioned for myself is nevertheless full, interesting, and rewarding. Its not how I thought things would turn out, but life doesnt always turn out the way you thought it would. Thats one of the major lessons that infertility (and endometriosis for that matter) teaches you. 

Ive often wondered what Id tell a woman in her 20s or 30s who has endometriosis and wonders if this disease will affect her own ability to bear children. From my vantage point, these are some of the things we might talk about:

• I would tell her to be hopeful. She should understand that infertility doesnt touch every single one of us. It does affect many of us, but not all. And for those who have difficulty conceiving, there are new fertility methods that can help and more are being discovered every day. There are also alternative methods for becoming a family (such as adoption) that can be considered.
• I would tell her to make haste. If she knows she wants to be a mother, she shouldnt delay. I realise that sounds strange in our modern world. Encouraging a woman to have children sooner rather than later seems so last century. What about her career? What if shes not ready? What if her mates not ready? I know, I know. Those are all things she should take into consideration. But she must also realise that age plays a huge role in fertility. Her ability to conceive will begin declining in her early 30s and will get progressively worse thereafter. Thats because women are born with all the eggs theyll ever have and when theyre gone, theyre gone. Thats for all women, not just those with endometriosis. If you throw endometriosis into the equation, theres even more of a reason not to delay.
• I would tell her to be aggressive. She should try on her own for six months. And by trying, I mean working it like a second job. That includes charting her temperature and using an ovulation predictor kit and having intercourse on a regular basis. If theres no pregnancy within six months, she should see a real reproductive specialist. And by real reproductive specialist, I mean someone who has the training, experience, and expertise to do all the fancy whiz-bang procedures not a doctor with a mere interest in infertility who decides to hang out a shingle.
• And finally, I would tell her to listen to her heart. As she makes decisions about her reproductive health, she will hear many voices and many opinions. Some are well-intentioned, some are not. I would remind her that this is her body and her choice. Only she can decide what is right for her.