Endometriosis and obstetric complications

11 November 20203′ read1 sections

Endometriosis and obstetric complications

Doctors propose ways to reduce obstetric complications in women with endometriosis

Endometriosis is a pathological process involving the growth of benign tissue (morphologically and functionally similar to the endometrium) outside the uterine cavity. In the premenstrual phase, the endometrium becomes thicker and, if the egg is not fertilised, it is shed from the uterine cavity with menstruation. This process is almost painless in healthy women, but in patients with endometriosis it is accompanied by inflammation of the surrounding tissues.

These patients suffer from chronic pelvic pain, menstrual cramps, painful intercourse and often infertility. Between 10% and 15% of women of reproductive age have endometriosis, and 30% to 40% experience complications during childbirth.

A team of doctors from RUDN University, together with their Italian colleagues, studied the data from existing studies on the effect of endometriosis on pregnancy and childbirth and proposed ways to reduce obstetric complications in women with this condition. The results of the work were published in The Journal of Maternal-Fetal & Neonatal Medicine.

Despite the prevalence of endometriosis, the patterns of obstetric complications have not yet been properly studied. The team of doctors from RUDN University and their Italian colleagues studied the data from previous work and proposed ways of preventing obstetric complications in women with this condition.

"Earlier studies focused on the biological factors that affect the course of pregnancy in women with endometriosis. We know that patients with endometriosis may experience miscarriage, preterm birth or other complications due to immune and endocrine disorders in the endometrium. However, the mechanism of obstetric complications is still unclear. That is why we carried out a systematic review of the literature and studied the effects of endometriosis on pregnancy, taking into account factors such as the method of treatment and conception, as well as the stage and location of the disease process. We also proposed ways of preventing obstetric complications in patients with a history of endometriosis," said one of the researchers.

The team analysed the results of previous studies, taking into account every possible complication: preterm birth, hypertensive complications in pregnancy, placental abnormalities, risk of caesarean section, fetal growth restriction and stillbirth. Based on the results of the study, the team proposed several methods for improving the pregnancy prognosis.

In particular, laparoscopy was cited as the main treatment option in the presence of adhesions. Laparoscopy is a modern surgical method that allows doctors to divide the adhesions between the peritoneum and the pelvic organs using special endoscopic instruments. This helps to treat infertility and reduces discomfort and pain in patients with endometriosis.

According to the team, methods of conception should be chosen according to the stage of the disease. It is recommended that patients with advanced stages of endometriosis undergo hormone treatment, and that women after surgery undergo in vitro fertilisation with embryo transfer (IVF / ET). The team proposed that all patients diagnosed with endometriosis should start taking 400 micrograms of folic acid before conception to reduce the risk of preterm birth.

"The results of different studies are conflicting: some did not take concurrent hormone treatment into account and some had methodological limitations. Nevertheless, we were able to build a fairly clear picture of all the possible obstetric complications in patients with endometriosis, establish causal relationships and identify issues for further discussion," the lead researcher concluded.

*The content of this blog is not intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of qualified healthcare providers with any questions you may have about a medical condition.

TAGSendometriosis

ABOUT THE DOCTOR

Dr. Alexandros Traianos

Gynecologist · Specialist in Reproductive Medicine and Fetal Medicine

He supports scientific excellence in clinical practice and recognizes the possibilities offered by modern reproductive methods to couples who wish to have a child of their own.

His profile

The content of this article is for information only and does not replace a medical examination and advice.

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Frequently Asked Questions most frequently.

Infertility is defined as the failure to achieve conception after one year (or 6 months in the case of a woman over the age of 35) of normal, regular sexual intercourse. In other words, when a year has passed without the woman becoming pregnant, the couple should consult their treating physician, so that the cause preventing pregnancy can be identified and subsequently addressed. However, we should all be aware and not forget that age is the most critical factor for female fertility, and that an individualized approach to each couple is the "golden key" that solves the problem.

Of course not. In approximately one third of cases, infertility is due to the woman (female factor), while in another third of cases it is due to the man (male factor). In the remaining third, it is due to both partners (both the man and the woman) or even to unknown factors.

• alcohol • narcotic substances • environmental toxins, including pesticides and lead • smoking • health problems • medications • radiotherapy and chemotherapy • age

In general, specialists agree that the fact that a couple has already had a child may be considered evidence that, at least initially, there is no infertility problem. It is like a small test that has been carried out and shows that they “succeeded” at least once. On the other hand, however, we should be aware that circumstances may have changed in the meantime and that a problem may have developed (e.g., the man may have had an inflammation affecting the quality of his sperm, or something may have occurred that affects female fertility: an inflammation, gynecological surgery, an abortion, etc.). In any case, therefore, if a reasonable period of time (one year) passes and a couple is unable to achieve a pregnancy, then, with the help of their doctor, they should investigate whether a problem causing infertility has arisen.

Success rates vary at each IVF center. Very important factors also include the woman’s age, her hormone levels, and, of course, her husband’s sperm. In general, rates are around 45% or slightly higher for women up to 35 years of age.

The number of treatment cycles a woman may undergo is not fixed. It is certain that in our country there are highly qualified obstetrician-gynecologists and well-organized infertility treatment centers that provide excellent medical services in this field. Provided that the appropriate indications are present (e.g., ovaries that respond to stimulation treatment, a good-quality endometrium, etc.), the success rate—particularly with the use of newer techniques and biotechnological medicines, which demonstrate increased bioactivity compared with conventional urine-derived medicines—reaches a cumulative rate of approximately 65%–70% after 4 treatment cycles.

Egg retrieval takes 10–15 minutes, is not painful, is performed under sedation, and after the procedure is completed you can return to your activities.

The association between IVF medications and the risk of developing cancer is the greatest concern for women participating in these programs. However, numerous literature references gathered from reliable scientific studies and published in reputable medical journals worldwide are reassuring and do not confirm this concern.

At Dr. Traianos' Reproductive Medicine Center, we offer egg and sperm cryopreservation services for individuals who have a personal or medical reason and require this service. We use the most advanced vitrification technique for the freezing of sperm and eggs.

Endometriosis and obstetric complications

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Frequently Asked Questions most frequently.

When is a couple considered infertile?

Is infertility only a female problem?

What increases the risk of male infertility?

I already have one child, but I am now having difficulty becoming pregnant again. Could a problem have arisen with me or with my partner?

What is the success rate of in vitro fertilization?

How many times can a woman undergo in vitro fertilization (IVF)?

Is egg retrieval painful?

Can IVF medications cause cancer?

Can I freeze my eggs or my sperm?