Endometriosis affects millions of women worldwide, often leading to challenges in conceiving. For women in Singapore who dream of starting a family, fertility treatments can be a lifeline.
In this article, we explore the connection between endometriosis and fertility and discuss the various treatment options.
How Endometriosis Affects Fertility
Endometriosis happens when tissue similar to the uterus lining grows outside the uterine cavity, resulting in pain, inflammation, and scarring. External tissue growth can interfere with fertility in several ways:
- Anatomical distortion: Scar tissue and adhesions can block or distort the fallopian tubes and ovaries, preventing the egg and sperm from meeting.
- Hormonal imbalance: Endometriosis can disrupt the hormonal environment necessary for ovulation, fertilisation, and implantation.
- Inflammation: Chronic inflammation may impair egg quality and sperm function.
- Reduced ovarian reserve: Women with endometriosis may experience a decrease in the number of eggs available for fertilisation.
Despite these challenges, many patients with endometriosis can get pregnant with the help of assisted reproductive technologies (ART).
Assisted Reproductive Technologies (ART)
Assisted Reproductive Technologies (ART) refer to a range of fertility treatments used to address infertility and help individuals or couples conceive. ART is often recommended for individuals facing fertility challenges due to conditions like endometriosis, unexplained infertility, or male factor infertility.
These techniques involve manipulating eggs, sperm, or embryos to increase the chances of pregnancy. Common ART methods include in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), and the use of donor eggs or sperm.
In Vitro Fertilisation (IVF)
IVF is a type of ART that helps individuals or couples achieve pregnancy. The process involves fertilising an egg with sperm outside the body in a laboratory setting to create an embryo. The embryo is then transferred to the uterus, where it may implant and develop into a pregnancy.
For women with endometriosis, IVF-fertilised eggs can bypass complications like blocked fallopian tubes, enhancing the chances of pregnancy.
Process
- Ovarian stimulation: Hormonal injections stimulate the production of multiple eggs.
- Egg retrieval: Eggs are collected using an ultrasound-guided needle.
- Fertilisation: Eggs are fertilised with sperm in a laboratory.
- Embryo culture: Fertilised eggs become embryos in over a few days.
- Embryo transfer: A healthy embryo is implanted in the uterus.
Success Rates
Success rates for IVF vary from patient to patient. The rate may decline with age or severe endometriosis.
Considerations
- IVF requires strict adherence to medication schedules and regular monitoring.
- Endometriosis may reduce egg quality, potentially impacting outcomes.
- Discuss any risks, such as ovarian hyperstimulation syndrome (OHSS), with your doctor.
Intracytoplasmic Sperm Injection (ICSI)
In standard IVF, eggs and sperm are combined in a laboratory dish, allowing the sperm to fertilise the eggs naturally without direct intervention. Intracytoplasmic Sperm Injection (ICSI), on the other hand, is a specialised procedure within IVF that directly delivers a single sperm into a mature egg to facilitate fertilisation.
This procedure is recommended for couples dealing with endometriosis alongside male factor infertility, such as low sperm count or poor motility, increasing the chances of successful fertilisation and embryo development.
Process
- Egg retrieval: Similar to IVF.
- Sperm selection: A single healthy sperm is chosen.
- Microinjection: The sperm is injected into the egg.
- Embryo transfer: A fertilised embryo is transferred to the uterus.
Success Rates
ICSI has comparable success rates to standard IVF. However, overall pregnancy success depends on embryo quality and implantation.
Considerations
- Additional laboratory procedures may increase costs.
Donor Egg or Sperm
For women with severe endometriosis or compromised ovarian reserve, using donor eggs can significantly enhance the chances of conception. Donor options also ensure high-quality genetic material for fertilisation.
Process
- Donor selection: Patients choose an egg or sperm donor based on medical and personal criteria.
- Ovarian stimulation or sperm retrieval: Depending on the scenario.
- Fertilisation and transfer: IVF or ICSI is used to create embryos for transfer.
Success Rates
The success rate for donor egg IVF is significantly higher, as donor eggs are usually from younger, healthier women.
Considerations
- The emotional and ethical implications of using the eggs of a donor must be carefully considered.
- Counselling is often recommended for couples exploring donor options.
Looking for fertility treatment for endometriosis in Singapore?
If you’re navigating the challenges of endometriosis and fertility, consulting a specialised clinic can make all the difference. CARE IVF offers personalised treatment plans tailored to your needs.
You will be cared for by experienced specialists, including our Medical Director Dr. Paul Tseng Seng Loke, Dr. Cheng Li Chang, Dr. Eunice Chua Kah Mui, Dr Fong Yang and Dr. Serene Lim. At every stage of your fertility treatment, they will share with you information relating to your condition while providing you with the care you need.