Pregnancy in women with endometriosis


Infertility in women of reproductive age can be caused by diseases such as endometriosis, which is linked to the presence of functionally active endometrial tissue outside the uterine cavity. Furthermore it may occur with different symptoms and not all the factors that cause it are known, so it is difficult to diagnose.


In order to achieve pregnancy in these women, all possible assisted reproduction treatments can be used, ranging from the simplest to the most complex depending on the extent of the disease.


The thickness of the uterus can also be affected by a variant of endometriosis, adenomyosis, which can reduce the embryo’s ability to implant and later develop. Its diagnosis is particularly important, although it is complicated and, to this effect, checks with three-dimensional ultrasounds need to be made.


The findings of a research developed in France to assess the obstetric and perinatal results in pregnancies following assisted reproduction treatment in women with endometriosis reveals that complications are more common. Therefore, bleeding during the first term, a risk of premature birth, pre-eclampsia and intrauterine growth restriction are more likely to occur, even the number of caesarean births is higher. All of these symptoms are linked to the severity of the endometriosis before gestation.


In order to carry out an early, accurate diagnosis and an effective follow-up for women with endometriosis, Instituto Bernabeu has a separate Unit that uses the latest techniques, such as innovative biochemical markers or realistic images provided by three-dimensional ultrasounds. In fact, a more comprehensive understanding of endometriosis and adenomyosis is gained through the checks that are part of the routine in this Unit and through researches that are being carried out to determine uterine implantation capacity depending on the severity of each case.


The Pregnancy Unit of Instituto Bernabeu has thus personalised and appropriate prenatal checks for those pregnancies achieved following assisted reproduction treatment and they are intensified in women with endometriosis. These women have also previous emotional stress, since they have been suffering unpleasant symptoms for years or have undergone unsuccessful treatments or even surgeries.


Pregnancy in women with this disease is classed as high-risk, so specialised healthcare experts must perform detailed checks more frequently. In this way, complications from endometriosis can be foreseen in order to have a successful pregnancy.



Source: Dr Francisco Sellers, Director of the Medical Unit at Instituto Bernabeu