Is endometriosis a "death sentence" to fertility?

[babybug]

Hi Doctor,
I posted a while back regarding how soon it is to see an RE. Thank you so much for answering. In the meantime, I have found a great obgyn who gave me a referral (waiting to get in, as wait list is long in my area) and addressed my concerns. I had some tests done including CD3 and CD21 bloodwork, husband had a SA - so far so good. Any further testing will have to be done by RE. However, based on my symptoms (severe/debilitating pain during period, long duration, also pain mid-cycle, constant pressure in lower abdomen, urinary issues and history of re-current rupture of corpus luteum cysts), obgyn highly suspects that I have endometriosis. He advised to discuss it further with RE, but in is opinion, lap to diagnose it is not necessary, as even if I do have it, there is no treatment for endo itself to improve fertility, and most likely protocol will be fertility treatments targeted to increase chances of conception, such as IUIs, progressing to IVF, but nothing to treat endo itself. Therefore, in his opinion, diagnosing it is moot point. Would you agree with that approach?

Is having endo detrimental on fertility? The information I have researched makes the prospects sound very depressing and gloom. Does endo automatically mean infertility or do some people with endo have positive outcomes?

Also, does endo only make getting pregnant difficult, or staying pregnant as well? Does it increase risks of chemical pregnancy and miscarriages? And if yes, will taking immune system drugs help? Do I have to worry about both?

Thank you so much.

[Dr. Wisot]

The key word is detrimental, certainly not a death sentence.

Sometimes a laparoscopy is helpful as endometrial implants can be cauterized or removed, as can endometriomas in the ovary. But many women do need need to have it done to proceed with fertility treatment. I would follow the RE's opinion on your need for surgery.

Treatment is much as your OB/GYN outlined to you. With new protocols we have been able to get success rates in endometriosis patients similar to those without it.
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Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

[babybug]

Thank you so much for quick reply!
In your professional opinion, if to conceive, does endo increase risks of miscarriage? The research I found was divided on the subject. Is it true that endo causes immune system to attack the embryo or produce toxins that kill the embryo or prevent implantation? Can different fertility treatments protocols mitigate those issues?

[Dr. Wisot]

Endometriosis is not thought to increase the risk of miscarriage.

We do not believe that those immunological theories are scientifically sound and proven.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California