A chronic condition, endometriosis happens when the tissue similar to uterine lining (endometrium) grows outside of the uterus, causing painful periods, pelvic pain, infertility, and heavy bleeding. For a 29-year-old woman, this severe condition was her reality. But, after suffering from it for five years, she was finally able to undergo treatment and conceive. She was under the care of a dedicated team of doctors led by Dr Padma Srivastava, consultant obstetrician and gynecologist at Motherhood Hospitals, Lullanagar, Pune. Read on to find out more about her case.
According to a statement made by the hospital sharing the details of her case, the patient had been suffering from symptoms of severe endometriosis for almost five years. She would experience excruciating pain during the first few days of her menstrual cycle. The condition had started to significantly affect her daily life; it also impacted her fertility.
Finally, she sought help at Motherhood Hospitals, where she was diagnosed with bilateral ovarian cysts and adhesions, which are complications that are commonly associated with endometriosis.
The doctors explained in the statement that endometriosis is a challenging condition, wherein the abnormal tissues can implant on various organs outside of the uterus, and lead to — as mentioned earlier — certain classic symptoms like pelvic pain, painful periods, and even infertility.
But, endometriosis is treatable. In fact, many women are also able to meet their fertility goals with appropriate care. Per the hospital statement, 6-10 per cent of women in India suffer from this condition. The incidence of infertility is ‘5-6 times higher’ than in general population. Interestingly, the chances of endometriosis diagnosis in a patient who presents with infertility issues is as high as 40-50 per cent.
In this patient’s case, Dr Srivastava discovered that she had developed bilateral ovarian cysts that measured 8 cm approximately, along with ‘significant adhesions’, which are ‘abnormal bands of fibrous tissue’ forming between organs; they can cause pain and infertility. A minimally-invasive procedure called laparoscopic cystectomy was performed to remove the cysts while preserving the ovaries.
The next part involved treatment for infertility. Dr Srivastava recommended intrauterine insemination (IUI) that involves placing washed and concentrated sperm directly into the uterus during ovulation, to increase the chance of successful fertilisation. “Women with endometriosis can conceive naturally, although infertility is more common. While IVF is often considered, it is not always necessary. Fertility-enhancing laparoscopic surgery can restore pelvic anatomy and improve ovarian function. Approximately 25-30 per cent of patients with endometriosis conceive with medication alone,” the doctor stated.
She added that to assess ovarian reserve, an Anti-Müllerian Hormone (AMH) test is needed. It can measure remaining egg supply and assess fertility potential. This test is recommended for women over 35, those with a history of infertility, and those considering fertility treatments. Even young women who want to understand more about their fertility can opt for it.