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Endometriosis and infertility

Endometriosis is a common condition in women of reproductive age in which endometrial tissue adheres to the outside of the uterus, the ovaries, and the fallopian tubes. In addition to pain, endometriosis may also reduce fertility. Although the prevalence of endometriosis in infertile women touches nearly 50%, not all women suffer from infertility.

Planning pregnancy with endometriosis
Endometriosis does not necessarily cause complete infertility but there is a higher risk of fertility-related problems. The fertility in the control groups of women with endometriosis attempting to become pregnant naturally is approximately half of that of a woman with pure unexplained infertility without endometriosis. Becoming pregnant may be more difficult for women with endometriosis. However, many women with endometriosis do get pregnant and have healthy babies.

Chances of endometriosis affecting fertility
Women diagnosed with endometriosis have 1/3rd of the monthly fecundity rate compared to a healthy woman. It ranges between 2 -10% per month. In a woman with mild or minimal endometriosis, small anatomical impact also decreases the chances of conception. The mechanisms include are distorted pelvic anatomy, endocrine and ovulatory abnormalities, altered peritoneal function, and altered hormonal and cell-mediated functions in the endometrium.

Consultation of IVF specialist regarding infertility due to endometriosis
Women with endometriosis associated infertility must consult IVF (In-vitro fertilization) specialist if following have been reported:

1.Compromised tubal function
2.Male factor infertility
3.Other treatment option have failed

Advice from the IVF specialists can help women to avoid arising complication in pregnancy.

Complications in pregnancy due to endometriosis
Endometriosis can increase risk of pregnancy complications because of inflammation, structural damage to the uterus, and hormonal changes.

Placenta previa
In some women, the placenta attaches to the bottom of the uterus at the opening of the cervix instead of top or side of the uterus. This is known as placenta previa. Women with endometriosis may be at increased risk of placenta previa. This can increase risk of ruptured placenta during labor, consequently severe bleeding occurs which may put baby in danger.

Reports have suggested higher rates of miscarriage in women with endometriosis than women with without endometriosis. If a woman is <12 weeks pregnant then miscarriage symptoms may resemble symptoms like bleeding, cramping, low back pain, etc. Preterm birth
According to an analysis of several studies, pregnant women with endometriosis are 1.5 times more likely than other expectant moms to deliver before 37 weeks of gestation. Premature babies tend to have a low birth weight and are more likely to experience health and developmental problems.

In recent times, due to the novel techniques and approaches being available, a drastic shift is being seen in the management of symptoms in women suffering from endometriosis. Novel and highly-bioavailable natural ingredients are being explored that are effective and safe and have been validated through several clinical studies for the successful management of Endometriosis.

Role of Curcumin, Resveratrol, N-acetylcysteine (NAC) and Vitamin D in decreasing chances of infertility

Production of free radical due to oxidative stress affects oocyte quality. Curcumin has antioxidant property. It protects oocyte by disrupting the mitochondrial activity. It also increases expression of KitL, a growth factor produced by the granuloma cells in the ovarian follicle. Curcumin also exhibits repairs effects on oocyte-granuloma cell interaction and the regulation of ovarian folliculogenesis. It has shown to reduce expression of all inflammatory mediators, cytokines, namely interleukin; IL-6, IL-8, TNF. All these effects can reduce risk of endometriosis associated infertility.

It conclusively and significantly reduced serum and peritoneal TNF (tumor necrosis factor) levels. It also decreases level of pro-inflammatory cytokines. It inhibits NF-KB (nuclear factor kappa light-chain enhancer of activated B cells) activation and prostaglandin synthesis via COX (cyclooxygenase) enzymes synthesis, thus reducing inflammation associated with endometriosis and decreases risk of complication in pregnancy.

N-acetylcysteine (NAC)
It suppresses the activation of NF-kB, an important transcriptional factor, by increasing glutathione levels. NF-kB plays a crucial role in endometriosis pathophysiology. NAC also acts as anti-inflammatory agent; decreases the inflammatory and invasive activity. NAC helps to reduce proliferative capabilities of endometrial cells through MMP-9 (Matrix metalloproteinase) reduction. Such endometriosis symptoms can rise risk of complication in pregnancy hence, by exerting these effects, NAC may help in decreasing risk of infertility.

Vitamin D
Women with higher levels of vitamin D have 24% lower risk of endometriosis than those in the lower quintile. There is a strong association between low levels of Vitamin D and increased risk of endometriosis.

Infertility is a common symptom of endometriosis. Altered ovary, uterus, embryo quality, distorted pelvic anatomy, endocrine abnormalities, altered peritoneal function, and changed hormonal and cell-mediated functions can cause endometriosis-associated infertility and may exert some complications during the pregnancy. While some people with endometriosis have fertility issues because of such condition, many get pregnant and deliver healthy babies. Treatment with nutritional supplement like curcumin, resveratrol and NAC may help women avoid risk of infertility and pregnancy complication and deliver healthy baby.

DISCLAIMER: The information published above is for educational purposes only and should not be used in any other manner. The information is not intended to substitute medical/professional advice. The information should not be used to diagnose or treat a health problem or disease without consulting a qualified

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