Egg freezing and endometriosis

Endometriosis is the second most common gynaecological condition after fibroids. It is estimated to affect 1 in 10 women of reproductive age, which equates to around 1.5 million people in the UK alone.  

For many of those affected, it is a debilitating condition with 95% saying that endometriosis has a negative impact on their wellbeing, 81% stating it contributes to negative or very negative mental health, and 89% revealing they feel isolated due to their endometriosis.

25 - 50% of women with endometriosis have fertility issues. If you have been diagnosed with endometriosis, you might be wondering what you can do to preserve your fertility as you navigate symptoms of and treatment for the disease.

To help you understand your options, this article discusses whether you can freeze your eggs if you have endometriosis and some of the key reasons to consider it.

What is endometriosis?

To explain what endometriosis is, it is first helpful to talk about the female anatomy. The uterus is a hollow, pear-shaped organ in your pelvis. It is in the uterus where a fertilised egg implants and a foetus (unborn baby) grows. The uterus has an inner lining of tissue called an endometrium and this is what you shed during your period, with a new lining generated during each menstrual cycle.

Endometriosis is a condition where similar tissue grows on or around other parts of the body outside the uterus such as the ovaries and fallopian tubes. In rarer cases, it can also occur on the bladder, cervix, intestines, stomach, rectum, or vagina.

The cause of endometriosis is unknown and there is currently no known way to prevent it. It also has no cure, but its symptoms can be treated with medication or surgery.

Symptoms of endometriosis

The most common symptom of endometriosis is severe pain in your abdomen or pelvis, especially during your period. While symptoms and their intensity do vary between individuals, other symptoms include:

• Chronic pelvic pain and back pain

• Pain when urinating

• Pain during or after sex

• Heavy bleeding during or between periods

• Digestive issues including stomach cramps, bloating, nausea, constipation, and diarrhoea

• Blood in your urine or faeces

• Fatigue

• Difficulty in falling pregnant

Does endometriosis affect fertility?

While endometriosis doesn’t necessarily cause infertility, it can make it more difficult to get pregnant. For couples within the normal reproductive age range without infertility, the likelihood of getting pregnant each month is around 15-20%. However, if the woman has untreated endometriosis, this falls to between 2% and 10%.

Howendometriosis impacts fertility is not fully understood but it is thought that damage to the fallopian tubes or ovaries makes it harder to conceive.

What is egg freezing?

Egg freezing is a fertility preservation procedure where eggs are collected from your ovaries, frozen and stored for future use. It is the fastest-growing fertility treatment in the UK, with 4,215 cycles taking place in 2021. There are many reasons why individuals choose to freeze their eggs, with mitigating the impact of endometriosis being one.

An egg freezing cycle usually takes two to three weeks and will require you to take hormone medication for a few days to mature the eggs in your ovaries while your clinic monitors you through scans and blood tests. Once your eggs reach a suitable size, you then undergo a short surgical procedure under sedation or anaesthesia where your eggs are collected using a fine, camera-guided needle. The mature eggs are then frozen and stored.

Can I or should I freeze my eggs if I have endometriosis?

Egg freezing can offer options for women who have endometriosis, especially for younger women when the condition is still earlier in its stages and before any surgery. There are several reasons why it is worth considering egg freezing if you have endometriosis:

Egg quality

When it comes to knowing at what age you should freeze your eggs, earlier is generally better. For women whose fertility is impacted by endometriosis, some find that by the time they come to seek help and commence treatment, they are older and their egg quality may have started to decline. This can result in treatment taking several cycles and there being less chance of success. However, freezing your eggs or creating embryos at a younger age with younger eggs means that your chances of success if you need fertility treatment in the future will be greater.

Egg count

Your egg count, or ovarian reserve, refers to the number of eggs you have remaining in your ovaries. You are born with all the eggs you will ever have, and the number naturally reduces when your ovaries release an egg during each menstrual cycle.

However, there is research to suggest that endometriosis can compromise your ovarian reserve. Endometriosis causes cysts, called endometriomas, on or around the reproductive organs. These cysts occur in 17-44% of people with endometriosis and studies have shown that the egg count of women with endometriomas is decreased compared to similarly aged healthy women or women with benign ovarian cysts.

Fertilisation

Endometriosis can cause inflammation and scar tissue to form in the pelvic region, including the ovaries and fallopian tubes. It is thought that this can make it harder for an egg to travel from the ovary to the uterus, preventing sperm from being able to fertilise it. In addition, endometriosis may also damage sperm or fertilised eggs before they implant in the lining of the uterus and make it more challenging for implantation to occur.

While freezing your eggs doesn’t guarantee a pregnancy, it can ensure your eggs are collected and preserved when they are of optimum quality to give IVF the best possible chance of success once you have your endometriosis under control.

Impact of surgery

Surgery is sometimes used to treat endometriosis by removing lesions, adhesions, and scar tissue. Like many other surgeries, however, there are risks associated with this treatment including damage to the uterus, fallopian tubes, and ovaries. Such damage can impact fertility so freezing your eggs before having any surgical treatment can help preserve your fertility by enabling you to use IVF to conceive at a later date.

Egg freezing with Apricity

Apricity is a next-generation fertility clinic, making fertility treatment easier and more accessible from the comfort of your home. We have expert fertility doctors, gynaecologists, and fertility nurses who have experience with endometriosis patients and are here to support you at every stage of your treatment with compassion and guidance, as well as signpost you to additional resources such as Endometriosis UK. 

Book a free consultation with one of our Fertility Advisors to find out more about how to freeze your eggs. During the call, you’ll have the opportunity to ask questions to help you understand the process, find out about our egg freezing packages and get personalised information about the cost of egg freezing.

References

• https://www.who.int/news-room/fact-sheets/detail/endometriosis

• https://pubmed.ncbi.nlm.nih.gov/19196878/

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941592/

• https://www.endometriosis-uk.org/sites/default/files/files/Endometriosis%20APPG%20Report%20Oct%202020.pdf

• https://www.nhs.uk/conditions/endometriosis/

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/endometriosis

• https://www.ncbi.nlm.nih.gov/books/NBK576440/

• https://www.nhs.uk/conditions/endometriosis/complications/

• https://link.springer.com/article/10.1007/s10815-016-0646-z

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6897522/

• https://www.hfea.gov.uk/about-us/news-and-press-releases/2023/latest-fertility-data-paints-promising-picture-but-pandemic-aftershocks-may-continue-to-be-felt-says-uk-regulator/