Infertility With Endometriosis

Endometriosis
 
A common condition, endometriosis is named after the endometrium, the spongy womb lining that develops every month. Endometriosis occurs when tissue similar to the endometrium starts growing outside the womb. It is most commonly found around the ovaries, womb, bowels or bladder. It is thought that 15 per cent of women may suffer from endometriosis, and many of them conceive naturally without any problems, but in some cases it can affect fertility.

Infertility With Endometriosis

The most common symptom of endometriosis is pain, either in the abdomen, the lower back or the pelvis. Some women find they have painful, heavy periods that may last longer than usual. There may be spotting or bleeding between periods, pain during sexual intercourse, and painful bowel movements or urination. Endometriosis can make you feel very tired or even exhausted. You are more likely to get endometriosis if you have heavy or long periods and a short cycle, if you began your periods at an early age and if you have a close relative who has endometriosis.

'I'd always suspected that everything wasn't quite right and started getting a lot of pain. I looked my symptoms up on the Internet and I kept coming up with endometriosis, It was the only thing that seemed to be related to bowel pain and period problems. There was at least a year when I was struggling on with pain every month, thinking that there was nothing wrong with me and I should be able to cope with it. Eventually I got referred to hospital and had a laparoscopy and I did have endometriosis,' Gillion, 30

Fibroids
 
Fibroids are benign tumors that grow in the womb. They are often found inside the layers of the wall of the womb, but they can also grow in the cavity of the womb or on the outer wall. Fibroids sometimes develop in the cent, or neck of the womb. They are made up of womb muscle fibre, and can grow as big as a melon. Fibroids are only extremely rarely cancerous, but they can affect your fertility because they can make it difficult for embryos to implant, and they are also associated with miscarriage.
 
The majority of women who have fibroids have no symptoms and are completely unaware that they have them. Symptoms may be more or less common depending on the size of the fibroids and their position. When there are symptoms, the most common is heavy menstrual bleeding. You may also have painful periods, bloating and lower back pain. Some women experience constipation or bladder problems. Studies have found that there is a higher incidence of fibroids among black women, although the reasons for this are not clear. Women who are overweight are also more at risk.
 
Blocked or scarred fallopian tubes 

If your fallopian tubes are blocked, scarred or damaged, eggs will find it difficult to get through them on their way from the ovaries to the womb. Fallopian tubes can be harmed by infection or by scar tissue if you have had any previous surgery in the pelvic area. Sometimes endometriosis can lead to tubal damage.
 
Pelvic inflammatory disease (PID) is a major cause of tubal problems, as it can lead to adhesions, or scar tissue, around the fallopian tubes. PID can be triggered by bacterial infection, but by far the most common cause nowadays is chlamydia, a sexually transmitted disease.
 
Young women are particularly at risk from chlamydia, as it is estimated that around 10 per cent of sexually active young people may have the disease, which often has no symptoms at all. A woman who has chlamydia is often completely unaware that she is infected, and yet it may be seriously damaging her chances of having a child in the future.
 
'I'd never heard of chlamydia until I was given a leaflet saying you could have it and not know about it, so I thought I might as well have the test. It came back that I had it. I had a course of antibiotics, but about two years after that they discovered the chlamydia had never cleared up. They said it was like a gluey substance that was sticking to everything like superglue, and sticking everything down. It had got so bad that it was untreatable. It was actually sticking to my internal organs.' Jeanette, 24

 
Those most at risk of getting pelvic inflammatory disease are younger women who have multiple sexual partners, who had their first sexual experience at a young age and who have a high frequency of intercourse. It can lead to ectopic pregnancy and women who have had PID often have repeated attacks. As with chlamydia, there are often no symptoms, although some women with PID have pain in the lower abdomen, painful intercourse, fever and vaginal discharge. To find out more, you can check out Infertility With Endometriosis.
 

Procedures For Infertility

The female reproductive system is incredibly complex, and one in six women find they have some difficulty getting pregnant when they want to. It isn't always easy to pin down where things are going wrong because subtle imbalances in our bodies can interrupt the finely balanced chain of events that sends mature eggs down the fallopian tubes to the womb. It is sometimes only once we find we have problems getting pregnant that we start to appreciate what an amazing process it is.
 

Procedures For Infertility

There is still much that we don't understand about female fertility and why some embryos implant successfully and others don't. Many women never discover why they can't conceive, as there are parts of the process doctors can't check and monitor. However, there are some common problems that may stop you getting pregnant.
 
Hormonal problems 

Around 20 per cent of fertility problems are caused by ovulation disorders. Women may not be releasing eggs at all, or may not be ovulating regularly. Sometimes, the ovaries don't produce mature follicles and the eggs can't develop properly. Ovulation can be disrupted at any point along the route that passes messages from the brain to the ovaries, and any kind of irregularity may stop eggs being released normally.

Polycystic ovary syndrome
 
Polycystic ovary syndrome, also known as PCOS, is a very common cause of female fertility problems. More than 20 per cent of women have polycystic ovaries, where small cysts are found just below the surface of the ovaries. These cysts are actually follicles that haven't developed properly. For most women, the cysts are not accompanied by any other symptoms and they still ovulate regularly, but some women also have other symptoms of PCOS.

If you have PCOS you will usually have irregular, infrequent or absent periods. This means you are not ovulating regularly, and your body may not be releasing mature eggs at all. The syndrome is often associated with weight problems, and about a third of women with PCOS are overweight. Women with PCOS are often told to try to get their weight down as this can improve their fertility, but unfortunately it can be harder to lose weight if you have PCOS.

Not everyone who has PCOS is overweight, and it is quite possible to have the syndrome and be very thin. PCOS often affects women who have eating disorders, and if you have bulimia you have a high risk of developing PCOS, even if your weight is normal.

There are some other signs that can accompany PCOS. You may have unwanted facial or body hair, and skin problems such as oily skin or ache. Some women also experience hair loss, or thinning hair. Women who have PCOS usually have imbalances in their hormones, and may produce higher than normal levels of testosterone. They may also have high levels of insulin, the hormone that regulates blood-sugar levels.
 
'I think I have had PCOS all my adult life. When I was 16, I came out in the worst acne of my life. I had very heavy periods, was very hairy, had dandruff... all the PCOS signs. I had blood tests and a vaginal scan, and they confirmed it was PCOS.' .Sarah, 34
 
Raised prolactin levels
 
Ovulation can also be disrupted by raised prolactin levels. Prolactin is a hormone that helps prepare women's breasts for milk-production after childbirth, but high levels in women who are not pregnant can affect the normal hormonal balance. The symptoms of raised prolaetin levels are irregular or absent periods, and you may also have a milky discharge from your breasts. Stress can cause prolactin levels to rise slightly, as can some types of medication.

Premature menopause
 
Also known as premature ovarian failure, premature menopause is usually defined as the onset of the menopause before the age of 40. It is thought that around 2 per cent of women have a premature menopause.

It is often not clear what makes the ovaries stop functioning normally at what ought to be the most fertile period of a woman's life, but it sometimes has genetic or chromosomal causes. A premature menopause may be the result of cancer treatment or autoimmune disorders.

 
If your mother had an early menopause, you are more at risk of this yourself, and if this is the case and you've already been trying to get pregnant unsuccessfully, you should seek medical advice sooner rather than later. Women who know they may be predisposed to a hereditary early menopause will usually be referred for treatment quickly if they are trying unsuccessfully to conceive, but doctors may be less willing to address the concerns of single women in this position who are worried about their future fertility. Once a woman has reached the menopause, the process is irreversible however early it may happen, and the only way to get pregnant is by using another woman's donated eggs.
 
'They did all the blood tests and they showed that my hormone levels were at the level of a 42-year-old. At the time I was 29. They said I wasn't going into the menopause right there and then but the likelihood was that I would go into an early menopause and not have any eggs, or the eggs might be bad quality.' Rachel, 35. To find out more, you can check out Procedures For Infertility.

 

Infertility Support Groups

Support groups
 
Some fertility clinics have their own support groups, or you may find a local group that is part of a bigger network.
There are a number of support organizations dealing with specific fertility problems and some of these have local groups that may hold occasional meetings. Support groups sometimes meet at local hospitals, at members, houses, or just get together at a local bar. Groups do vary considerably. Some of the well-established support groups are very organized and lend books and videos, arrange social events or visiting speakers and may even produce their own newsletters.

It can seem daunting to turn up at a meeting with a roomful of strangers when the only thing you have in common is the difficulty you are having getting pregnant, and support groups may not be suitable for everyone, but many people do find them really helpful.

Infertility Support Groups

'I think a support group is a wonderful thing. I did have people I could talk to, but you reach a point where you think you are going to bore everybody, and you don't want to keep moaning all the time. In a support group, people understand and they don't judge you,' Gillian, 30 

For some women, the thought of joining a support group can be one step too far, as it can seem as if you are accepting your infertility, which you hope will be short-lived, as a real long-term problem.

'I looked on the Internet for local groups and I couldn't decide whether I wanted to meet people in the same situation or whether I really didn't at all. I had second thoughts about doing anything like that because it made it more real. I almost didn't want to be part of a group who were infertile women because I didn't want to accept l was one of them.' Rachel, 31

Support groups used to be the only way of getting in touch with others with the same problem, but now many people prefer not to have to go out and face what they fear could be an awkward meeting with a group of strangers. The popularity of traditional support groups has declined in recent years as the Internet has taken over as a way of getting in touch, and some support groups find they are more successful when they arrange casual meetings in bars or cafes, rather than the more formal hospital setting.
 
Internet support 

Fertility support on the Internet has become hugely popular, and there are any number of online support networks that will help you to find other people who have the same fertility problem, who are going through the same tests and treatment, and who may even be at the same clinic. There is always someone to talk to, help is there whenever you need it, and you don't need to leave your home to access it. Many women find themselves online friends, or 'cycle buddies', who are going through treatment at the same time, and find it really useful to be able to discuss their experiences as they happen.
 
'There were six or seven of us who were starting a cycle at the same time and we went through the whole month on a forum talking it through. It was incredibly helpful. It was small things like the first time you have to inject yourself, it was really useful to go on and read somebody else saying it wasn't as bad as they thought. It made it much less scary.' Nicol, 33

When you first start using the fertility websites, it can be hard to work out what on earth people are talking about. If someone tells you they and their dh have been ttc for four years, have just been through their 2ww after IVF and had a BFN, you may be completely confused. This means they and their partner (dh - dear husband) have been trying to conceive (ttc) for four years, have just been through the two weeks of waiting to find out whether they are pregnant (2ww) after having IVF and have been unsuccessful (BFN - big fat negative). Fortunately, most sites have a page translating all the abbreviations and you may find yourself whizzing back to them a lot at first.
 

Although many women find Internet support absolutely invaluable, you should bear in mind the fact that postings on message boards are from other patients, and some of the advice and information they give may not be medically accurate. At the same time, for a patient's-eye view of treatment, they are incredibly useful.
 
For some women, even Internet support feels too intrusive, whereas others don't like the idea of talking intimately to people they don't know. In those circumstance, the information produced by national support networks and books about infertility can prove a godsend.
 
The main benefit of any kind of support wherever you prefer to find it is the realization that you are not the only woman living with this, that there are many others out there who are going through exactly the same thing and experiencing the same emotions. To find out more, you can check out Infertility Support Groups. 

 

What Are Some Tips To Getting Pregnant

Counseling and support
 
Counseling should be offered at any clinic that carries out fertility treatment. You may feel you don't need counseling, but it can really help with the emotional trauma of not being able to have a child, and is often beneficial if you end up having fertility treatment. It is worth checking whether counseling is included in the cost of any treatment. You may also want to know whether there is a counselor on site, or whether you would be expected to see someone elsewhere.
 

What Are Some Tips To Getting Pregnant

Some women feel uneasy about seeing a counselor, as if it is an admission that you are not coping, but counseling can make all the difference to how you feel about your situation, particularly if you find someone you like and trust.
 
'We had no support from family, and friends were limited, so we had to revert to the counseling that the hospital provides, and it was wonderful. It really was an outlet for us. We went very regularly, every four weeks, for a long time. It was just nice to be able to talk about our problems.' Emma, 38 

Lesbian couples and single women 

Single women and lesbian couples may find that not all clinics will treat them, although the situation has changed considerably in the last few years and there is much less prejudice about this. Attitudes do vary from clinic to clinic, and if you have a choice it may be worth gauging the reception you will get before coming to a decision.
 
'I did phone around clinics and some were quite blatant, and actually quite rude, just saying they didn't deal with lesbians. At some points I did feel like the door was being slammed in our face, but we did find clinics that would deal with us.' Sarah, 28
 
Reputation
 
The vast majority of fertility consultants and clinics are highly reputable and their services are closely monitored to ensure they maintain good standards, but some patients do feel unhappy with their treatment. There should be a proper complaints procedure in place at every clinic if you are concerned about something, and if you have any doubts about the treatment you are being offered, you should make sure they are answered before you agree to go ahead. Really thorough research is undoubtedly helpful if you have a choice of clinics.
 
'I looked up IVF clinics, went to visit all the different doctors and as soon as I came out of the consultation I wrote a list of the pros and cons of each doctor, I put down everything from the smallest detail, things like how I felt when I walked into the clinic and whether I liked the receptionist, all the prices and that kind of thing, everything I could possibly drag out of my head. I just weighed them all up.' Debbie, 44 

Telling other people
 
Some couples tell their friends and family as soon as they make the decision to start trying to have a baby, which means they will realize fairly soon that things aren't going according to plan. If you haven't told anyone you're trying, you may start feeling pressured by people asking you when you're going to get round to it, and sometimes it is easier just to be honest and say it is taking longer than you hoped, which will usually put an end to the conversation. It is common not to want to tell people you've been trying unsuccessfully, as this may feel like admitting something is wrong when you haven't really come to terms with that fact yourself.
 

How you feel about telling people depends a lot on your relationships with individuals, whether they are members of your family or friends. Some people don't understand and don't know how to deal with it, whereas others are very sympathetic. It can be helpful to have a friend to confide in if you are feeling upset, but people don't always react in the way that you would hope, and one of the most common complaints is that other people just can't seem to say the right thing. You are probably quite sensitive, and although your friends and family may be trying to be helpful, it won't always feel that way.
 
'You can't talk to anybody about it because they just don't understand. Unless you've been through it you haven't got a clue. It can be difficult but you just put up with it and put on a brave face.' Nikki, 35. To find out more, you can check out What Are Some Tips To Getting Pregnant.