Infertility Facts Related
How Endometriosis affects your fertility
Endometriosis infertility Facts and Treatments
Patients with endometriosis may experience:
· Longer follicular phase (problem with LH surge)
· Luteal phase defects with lower progesterone
· Fewer follicles (eggs) in the ovary with substantial decrease in ovarian reserve after multiple surgeries
· Decreased oocyte quality
· Decreased ovulation
· Increased luteinized un-ruptured follicle syndrome
· Problems with fertilization
· Poor sperm binding and motility
The peritoneal fluid of women with endometriosis may contain elements like Interlukins ( IL-6 ) which reduce sperm motility. Women with endometriosis have increased peritoneal macrophages will can destroy sperm.
Endometriosis is associated with poor embryo quality and arrest of embryo development. GNRH agonist may improve embryo quality.
Endometriosis is associated with decreased implantation due to decreased integrins expression αVβ3, which can lead to reduced uterine receptivity.
Endometriosis is associated with increased spontaneous abortions up to 33%.
In vitro fertilization (IVF)
The most effective treatment for women with advanced stage endometriosis (Stage III and Stage IV). GnRh agonist treatment prior to IVF has been shown to improve IVF success rate.
Natural transfer when the embryos are frozen and subsequently transferred in another cycle has been shown to be very beneficial in increasing the pregnancy rates with IVF. This could be explained by the fact that high estrogen levels during an IVF cycle can have inhibitory effects on progesterone. This effect is eliminated if the embryos are transferred in another cycle.
At Advanced Fertility Center of Texas we believe that many patients with endometriosis benefit from IVF with a Natural transfer (postponed embryo transfer).