In vitro fertilization (IVF) is a relatively successful fertility treatment for women struggling with infertility. One's chances of successfully carrying a pregnancy through IVF depend on certain factors, like the presence of endometriosis. Endometriosis may play a part in IVF failure as it alters the reproductive environment. Here's an in-depth look at the condition and its correlation with IVF failure:
Endometriosis is a condition characterized by the growth of endometrial tissue outside the uterus. The tissue may grow in the fallopian tubes, ovaries, and around the pelvis. Common symptoms of endometriosis include painful periods, heavy menstrual bleeding, pain during intercourse, fatigue, constipation, and pain with bowel movements during a menstrual period. Some patients have silent endometriosis, so they don't experience these symptoms. For many, endometriosis only becomes a concern when they seek infertility treatment. Endometriosis may make it more difficult for one to get pregnant.
A fertility specialist may recommend IVF if one has difficulty getting pregnant. IVF is an assistive reproductive technology that involves combining eggs and sperm outside the womb and placing the resulting embryos into the womb. Endometriosis may prevent the treatment's success because of its impact on the ovaries and uterus.
The condition may impact one's ovarian reserve if endometriomas form around the ovaries. Endometriomas are cysts that develop when endometrial tissue grows outside the uterus. They may reduce one's egg quality and quantity, resulting in fewer viable eggs during the IVF egg retrieval cycle. Fertility specialists typically need to retrieve many eggs to improve the chances of successful fertilization. Retrieving a few eggs may reduce the chances of successful fertilization and embryo transfer, resulting in IVF failure. Reduced egg quality may also lower oocyte and embryo quality, affecting IVF success.
Endometriosis may also cause poor embryo implantation, which can cause IVF failure. The illness may result in progesterone resistance, preventing the hormone from preparing the uterine lining for embryo implantation. Progesterone typically supports pregnancy by thickening the uterine lining. Without it, IVF patients may be unable to carry a pregnancy, regardless of the embryo quality.
IVF patients with poor outcomes need to meet with their doctors to determine the next steps in treatment. Fertility specialists may order endometriosis tests if they suspect the condition is responsible for the failure. Common procedures used to test for endometriosis include transvaginal ultrasounds, magnetic resonance imaging (MRI) tests, laparoscopies, and BCL6 tests.
Transvaginal ultrasounds provide visuals on one's reproductive system, so they may help highlight endometriomas. MRIs offer more detailed images than ultrasounds and may help determine the extent of endometriosis. Laparoscopies involve making small incisions around the abdomen and using a small camera to look for endometriomas. Doctors may remove tissue samples during laparoscopies if they find suspicious growths for further testing. The tissues may be tested for BCL6 markers to determine if patients have endometriosis. BCL6 is a protein biomarker associated with inflammation. This means elevated BCL6 scores may indicate endometriosis.
Fertility specialists may recommend trying IVF again if the tests are negative for endometriosis. If the tests are positive for endometriosis, specialists may recommend first undergoing treatment to improve the chances of success. Treatment may entail hormone therapy or laparoscopic surgery. Hormone therapy may slow the growth of endometriosis implants, whereas laparoscopy may remove existing implants. In severe endometriosis cases, doctors may recommend laparoscopies followed by hormone treatments to manage endometriosis. After treatment, one may need to wait several months before trying IVF.
Endometriosis may cause infertility and IVF failure. The condition may cause ovarian cysts, affecting egg quality and quantity. Low egg quality and quantity may reduce the chances of a successful pregnancy. Endometriosis may also create a poor uterine environment, lowering the chances of successful embryo implantation. Undergoing endometriosis testing and treatment may better one's chances of getting pregnant.