Among the medical problems of women's reproductive health, endometriosis and pregnancy take a special place. That is, the probability of pregnancy with endometriosis - a gynecological pathology that appears in the abnormal proliferation of cells of the glandular inner layer of the uterus (endometrium) beyond its cavity.
This problem is topical, since endometriosis is considered not only one of the main reasons for gynecological operations, but also the leading cause of female infertility and chronic pelvic pain.
But, despite the fact that up to 30-35% of women with endometriosis have problems with conception, the question is - is pregnancy possible with endometriosis? - gynecologists give an affirmative answer.
Why does not pregnancy occur during endometriosis?
Experts do not recommend identifying endometriosis with infertility: in women with this disease, the pregnancy test for endometriosis can be positive, because the possibility of becoming pregnant depends on the type and localization of dyshormonal endometroid heterosis, and also on the degree of cicatricial-adhesive process characteristic of endometriosis. However, the negative impact of this disease on fertility is also not to be ignored.
It should be noted that the types of pathology in the form of genital and extragenital endometriosis differ localization: either on the organs of the reproductive system, or on the structures and organs of the small pelvis and abdominal cavity. But in any case, their displacement relative to the normal position with various functional disorders occurs. Clinical varieties of genital endometriosis is the defeat of the ovaries, fallopian tubes, uterine ligaments, and then there is a problem - external endometriosis and pregnancy, with the level of secondary infertility to 25% of cases.
With endometrial heterosis of the cervix, cervical canal and myometrium (muscle shell), the problem is formulated as internal endometriosis of the uterus and pregnancy. Since endometriosis of the myometrium - adenomyosis of the uterus - can occur in parallel with the uterine myoma, women face such a dual problem as pregnancy with myoma and endometriosis, when the chances of motherhood are minimal. In addition, if pregnancy does occur, the nodes of myoma begin to grow, which increases the risk of interruption.
In the extragenital proliferation of tissues, similar to the inner lining of the uterine cavity, the bladder and urethra, the navel and the anterior abdominal wall are mostly affected, especially in the presence of postoperative scars.
But why does not pregnancy occur during endometriosis? Here are a few examples.
Endometriosis of the cervix and pregnancy: problems with conception arise due to the formation of a cyst (one or several) in the cervical canal, which leads to its deformation and narrowing.
Retrocervical endometriosis and pregnancy: in this rather rare type of pathology, endometrial tissue is found on the back of the cervix with extension to the posterior vaginal vault, septum between the vagina and rectum, intestines, urinary tracts, and also to the muscular walls of the uterus. And, according to experts, this complicates the conception, and the treatment of this clinical problem can be solved in isolated cases.
Endometriosis of the ovary and pregnancy: due to the proximity of the ovaries to the uterus, this is one of the most common places of development of endometriosis. Due to the appearance of endometrioid cysts of the ovaries, the functions of their follicular apparatus, that is, the ability to form eggs and synthesize hormones, are noted. See more details - Endometrioid cyst. Endometriosis of the ovaries is the most likely cause of infertility.
Endometriosis of fallopian tubes and pregnancy: the formation of external (peritubar) adhesions can lead to stenosis or complete obstruction of the fallopian tubes. In such cases, a fertilized egg simply can not enter the uterine cavity, and with this localization of pathology, there is often an ectopic (extrauterine) pregnancy.