IVF in endometriosis and adenomyosis: What are the chances of a successful conception

Today, endometriosis diagnosed in 7% of the fairer sex in the age group from 15 to 50 years. Women who go to the doctor about the inability to get pregnant, the pathology is detected in more than 35% of cases. In each case, a fifth IVF in endometriosis.

In the chronic advanced stage pathology is irreversible adhesive processes in which conception becomes impossible. When using in vitro fertilization procedures chances of a successful pregnancy repeatedly increases because sits fertilized egg directly into the uterus.

The effect on the reproductive system endometriosis

Any imbalance in the female reproductive system can cause irreversible processes.

Growth of internal endometrial lining the uterus, provokes inflammation, which further contributes to the top of adhesions, infertility.

The causes of endometriosis are not fully elucidated, but the basic preconditions for its development are:

• hormonal imbalance;
• traumatic violation of endometrial uterine curettage, abortion;
• uncontrolled wearing IUD and oral contraceptives.

The pathology is characterized by unexpressed symptoms, the main of which are considered to be a failure cycle, acyclic bleeding, problems in the process of carrying a child and infertility. Even with a successful conception of the disease is the cause of spontaneous abortion, placental abruption, fetal growth abnormalities.

Pathological changes of the endometrium reduces the chances of the attachment of the ovum in the uterine wall, inflammatory foci in the abdominal cavity leads to the formation of adhesions causing obstruction of pipes. There is impairment of fertility, ovulation, menstruation.

reproductive system performance can be improved by hormone therapy Only one-third of all cases of endometriosis. Launched in the early stages of the disease therapy can restore cycle, normalize ovulation, making it possible to conceive. In other cases, hormone treatment does not work, use a surgical shoe that eliminates the pathologic tissue proliferation, but does not contribute to fertilization, because adhesions It remains.

Is it possible to do IVF in endometriosis

Endometriosis IVF is carried out only after prior therapy. It includes the following steps:

1. The first 3-6 months after diagnosis of the disease should be conservative hormonal therapy. Also used are symptomatic anti-inflammatory, antibacterial, sedative and other means aimed at the relief of pain and reduce inflammation.
2. If after this period the growth of the endometrium does not stop, the disease is compounded adhesive process, surgical treatment is used. It is a surgical scraping abnormally overgrown endometrial tissue. In parallel, the study material to determine the cause of pathology.

Only then do IVF. By the time of replanting egg function reproductive organ, tubes, ovaries should be fully restored.

In the presence of endometriosis to conduct in vitro fertilization is not always resort. A successful pregnancy with pathology may fail to increase the risk of spontaneous abortion.

The chances of successful IVF

adenomyosis and eco - compatible concepts, but in the presence of this disease the probability of successful fertilization is significantly reduced:

• the first and second stages of endometriosis successful attachment of the egg occurs in no more than 30% of women;
• the third and fourth - a maximum of 14%.

Successful conception depends not only on the extent of the disease. The following factors are also important:

• general state of health of the woman;
• age;
• lifestyle, bad habits;
• background and concomitant diseases.

Artificial insemination is now the most effective way of getting pregnant with infertility. After the treatment of endometriosis, doctors resort to expectant management, when the period of 12 months is recommended for women having sex without contraception. If pregnancy after one year does not occur, appointed IVF or insemination (while maintaining patency of pipes).

Preparation for IVF in endometriosis

Prepare for IVF with adenomyosis in advance as it affects the probability of conception. Shall be drawn up taking into account the general state of health of the woman, the presence of pathological processes, the work of the reproductive system.

Preliminary reports are divided into long and super-long. Their aim is to stimulate ovulation for the production of an increasing number of high-quality eggs.

In preparation for the woman administered agonist of gonadotropin-releasing hormone, gonadotropin. These hormones are necessary for the restoration of ovulation. Treatment lasts until the moment when the art can obtain necessary characteristics of the egg.

There are daily ultrasound. Once the follicles reach 18-20 mm, is assigned to the reception of the hormone hCG for ovulation. In the following 36 hours of specialist performs sampling of eggs through ovarian puncture. The procedure is repeated until, until the desired biological material is extracted.

If the growth of endometrial tissue has reached the 3rd or 4th stage appointed super-long protocol, under which conduct proper hormonal stimulation. It lasts for a maximum of six months.

Features procedures

Artificial insemination is not always assigned immediately after diagnosis. It is conducted on the basis of the following nuances:

1. At the initial stage of pathology selected watchful waiting for one year. At this time the steam shall attempt natural conception.
2. If diagnosed with obstruction of the tubes is carried out pre-stimulation of ovulation and then insemination performed with sperm partner. This method is the most successful in half of all cases.
3. Watchful waiting is not used in women over 35 years. At the age of 40-45 years is appointed immediately after IVF laparoscopy and prior hormonal treatment.
4. In the latter stages of endometriosis using super-long records of up to 6 months. During this time, stimulated ovulation, experts are making a large number of healthy eggs, so the chances of successful conception are increased.

Also takes into account the follicular reserve. It is defined by antimyullerovu hormone (AMH) and the number of antral follicles. To the implantation was successful, they can be assigned to preparations for restoration of uterine blood flow, which is important for carrying podsazhennyh embryos.

Will result

The average in vitro fertilization success in endometriosis is 14-50%. Chances are higher in women with a good cross pipe and a large follicular reserve.

Before starting the procedure it is important to get a healthy egg and the uterine cavity as much as possible to prepare for the successful attachment of the embryo. To this end, always use the super-long or long protocol IVF ovarian hyperstimulation to the reproductive system of the woman was ready for pregnancy.

But even then not always possible to keep the baby. It all depends on the characteristics of the mother, her age, presence of chronic diseases, congenital anomalies of the uterus and other organs of the structure.

It is strictly forbidden to conduct artificial insemination in diabetes mellitus in severe, liver failure, ulcerative colitis, mental disorders and anatomical anomalies of sex authorities.

Unfortunately, not always IVF gives the result, so we recommend to get acquainted with the nuances of menstruation after unsuccessful IVF.

Advantages and disadvantages

The main advantage of the procedure allows you to assign IVF to women diagnosed with endometriosis, it is the ability to get pregnant with a relatively small time training. Long protocol runs for 3 weeks, after which it is possible replanting embryos.

At older ages, and in the presence of 3-4-th stage of adenomyosis using super-long protocol, which involves the use of the same drugs, but for up to 3-6 months.

The downside of the procedure is a contraindication. IVF should not be prescribed in case of problems with the liver, kidneys, stomach, with insulin dependent diabetes.

At congenial endometriosis pregnancy often occurs naturally within 8-12 months after treatment. Only if this does not happen, use IVF, insemination (injection of sperm syringe) or ICSI.

A significant problem in vitro fertilization in women with endometriosis is the poor quality of oocytes, embryos and defective implants. Chances of conceiving rise if within 3-6 months, conducted drug therapy to inhibit the growth of endometrial formations.

Artificial replanting already fertilized egg is sometimes the only possibility for a woman to become a mother. To date, as part of this technique came to light more than 7 million people. The procedure makes it possible to not only conceive with endometriosis, but also in other diseases of the uterus, tubes obstruction.