Diagnosed with endometriosis? Here's 3 ways to support your fertility

PSA:  If you have been diagnosed with endometriosis, you have certainly not been diagnosed with infertility.  Research has shown that somewhere between 70 and 50% of women diagnosed with endo will become pregnant naturally within 12 months of trying.

How can you tell if you’ll fall into the ‘will conceive in a year’ group?  Unfortunately, you can’t know until you start trying.  Here’s 3 tips to get started on your conception journey and to support your unique fertility needs.

1.  Identify your fertile days - and if sex is painful, you have options.

Plenty of women with endometriosis conceive naturally.  With or without endo, research has shown that women who track their cycles become pregnant sooner.  You’ll find information here on understanding your fertile days (complete with a bus stop and sperm passenger analogy).

What if trying is painful? More than half of people with endometriosis experience deep dyspareunia, or ‘pelvic pain with deep vaginal penetration’.

For endo warriors (or anyone) who experiences pelvic pain with deep penetration, the ingenious OhNut comes highly recommended by patients of mine who are trying to conceive.

2. Support egg quality

Research on donor eggs from people with endometriosis goes as far back as at least the early 1990’s, when it was found that donor eggs from women with endometriosis were less likely to go on to be successful. More recently, IVF research has found that that eggs from women with endometriosis are more likely to have altered morphology and they were likely to have fewer mature eggs collected.

Supporting egg quality is particularly important for our endo warriors.

Research from 2018 points toward increased oxidative damage being a key component in the poorer egg quality seen in women with endo. To counteract this, our best bet is antioxidants - I’ve written a lot about antioxidants and free radicals both on the website in more detail in my ebook, they play such an important role in protecting our eggs.

Time to bump up your antioxidants. Nope, you don’t need them all - it’s best to speak to a practitioner to ascertain what is the best option for you, the best dosage and to ensure no interactions with other supplements or medications. Consider:

• N-acetylcysteine (aka NAC) is an amino acid which is used by the body to build antioxidants. As a bonus - it also has powerful anti inflammatory actions on the tissues of the body

• Ubiquinol: An antioxidant and the active form of CoQ10, ubiquinol has been found to support egg quality.

• Alpha Lipoic Acid: this antioxidant has also been shown to have a positive impact on egg maturation and fertilisation and has a role supporting energy production of cells.

3. Support implantation

Once that little egg has been fertilised, it needs to implant! Studies from the IVF world have shown that implantation rate is likely to be lower for people with endo, than those without. Researchers have hypothesised that inflammation plays an important role - so for our patients with endo we look at minimising inflammation to support implantation

• Acupuncture has been shown to be a useful first line or adjunct therapy for chronic inflammation - bonus, it helps with pain too

• Omega 3 fatty acids partly inhibit aspects of inflammation while driving the mediators that reduce and resolve inflammation - if you don’t eat much fish, consider a supplement.

Next steps

I’d encourage patients with endometriosis to consider further pelvic investigation a little earlier than I would for most couples just starting out trying. It is important to rule out mechanical blockages that prevent the egg and sperm meeting in the fallopian tube, not entirely uncommon for women with endometriosis.

Please don’t be scared. Solid preconception care with an endo-fied tweak, a team to support you, and giving it a go is the best way to start trying to conceive.