Struggling with fertility complications is emotionally and mentally excruciating. Feeling as though your body is incapable of doing something so basic can deflate your self-esteem. Unfortunately, many reproductive disorders make conception a heartbreaking challenge. And, adenomyosis is one of those diseases that leads to fertility struggles for many women. 

Fertility Complications: What Causes Them?

One of the most common issues associated with adenomyosis and fertility is miscarriage notably, recurrent miscarriage. As a matter of fact actress, Gabrielle Union has been vocal about sharing her experience with undiagnosed adenomyosis and how it impacted her fertility journey. In her memoir, she shares how over three years, she underwent numerous IVF cycles and experienced over 8-9 miscarriages. It wasn’t until the end of her fertility journey that she learned that adenomyosis could’ve played a significant role in her infertility. 

Yet, the mystery behind how and why adenomyosis impacts reproductive health isn’t always apparent. But, suspicions involving implantation issues due to an enlarged uterus and uterine contractility both play a role in fertility complications for women with adenomyosis. 

 

Possible Reasons Implantation Fails

Implantation is one of the most critical parts of conception. It involves the embryo attaching itself to the uterine wall and signifies the beginning of life and pregnancy. Even though this process is miraculous, many factors impede implantation and increase miscarriage. 

Chronic Inflammation

I think we all know how chronic inflammation creates a toxic environment within the body. An increase in pro-inflammatory proteins disrupts many healthy processes within the body. And fertility and reproductive health are no different. Indeed, chronic inflammation can affect the health and function of the embryo. Thus, interfering with fertilization and implantation on the uterine wall.

fertility complications

Uterine Abnormality

Adenomyosis is responsible for endometrial tissue growing into and within the uterine wall. Thus, causing the uterus to become enlarged and excessively thickened. In turn, these issues lead to fertility complications that interfere with implantation and increase the risk of miscarriage. 

Studies conducted on infertile patients undergoing IVF discovered that those with a diffusely enlarged uterus without the presence of uterine masses had an increased occurrence of implantation failure and miscarriage. 

Uterine Contractility

Those with adenomyosis surely can attest to the bouts of chronic pelvic pain and cramping described as “false labor pains” or contractions. Consequently, inflammation from adenomyosis tissue is the leading cause of the convulsions and tightening of the uterine muscles. Furthermore, the intense pelvic cramping and uterine contractions lead to fertility complications since they prevent implantation and increase the risk of miscarriage. 

 

Overcoming Fertility Complications

Just because adenomyosis presents increased challenges when it comes to becoming pregnant doesn’t mean it’s hopeless and a lost cause. Depending on your unique health and your specific case is what will determine the next steps in your fertility journey. And, there are many factors to consider. 

overcoming fertility complications

Surgery and Medical Intervention

An excellent place to start before undergoing fertility treatments will be to determine if medical therapy or conservative uterus sparing surgery is for you. Many studies have shown an increase in successful pregnancies when medical treatment in the form of gonadotrophin-releasing hormones (GnRH) is administered or when uterus sparing surgery is performed. Although, it’s important to note that there has been no clear benefit of fertility outcome for women in their 40’s that undergo surgical intervention. 

Down-Regulation Period

In many cases, a medical professional may recommend the use of GnRH medications to decrease fertility complications. These medications turn the ovaries off to control ovulation and egg development during treatment. Furthermore, this period can last for 2 1/2 to 4 1/2 weeks or longer if deemed appropriate.

Conservative Surgery

It’s debatable whether surgery is beneficial in treating adenomyosis, especially laparoscopic localized cytoreductive surgery. Indeed surgical procedures may cause more harm than good due to the high level of skill and technique required to operate and preserve a woman’s fertility. Hence why, this surgery is typically performed on for those that have adenomyosis in one focal area, such as an adenomyoma. Additionally, you want to make sure that you’re working with a surgeon that has experience with adenomyosis specifically this type of surgery in. On the other hand, uterus sparing surgery can be useful in increasing fertility for many women. Again, each case is different, discuss risks and benefits with your surgeon. 

discuss fertility options with your spouse

Combined Treatment

Yet still, in other cases, your doctor may recommend both medical and surgical intervention. It’s normal for you to undergo a down-regulation period, either pre-surgery or post-surgery. And once you’ve experienced this process, your doctor will recommend when it’s best to begin fertility treatments after evaluating your progress post-treatment.

Assisted Reproductive Technologies

Thank goodness for advancements in technology and medicine. It’s because of this that reproductive options such as intrauterine insemination (IUI) and in vitro fertilization (IVF) can assist many couples in their procreation journeys. Yet, it can be a financially, emotionally, mentally and physically exhausting option. And, it shouldn’t be something that’s entered into lightly. Working with a qualified professional that runs the appropriate diagnostic tests and determines if you’re a proper candidate can help with setting expectations and leading to a successful outcome.

Consider All Your Outcomes

Discovering you have a decreased chance of getting pregnant due to chronic illness can be challenging to digest. Yet, taking the time to assess your condition and determine what fertility options are available to you is a terrific first step. Seeking out the guidance of a fertility specialist can aid in improving your conception odds and provide clarity of which treatments are best suited for you. For starters, they can help identify what’s causing your fertility complications and determine appropriate therapies for treatment. Additionally, they can inform you of which fertility options will be best for you and your partner. 

Furthermore, having conversations with your partner about what you can afford financially and what each of you are willing to do to start your family is necessary. Have open discussions and determine what treatments and therapies you’re ok with and the ones you aren’t. Additionally, knowing how much your insurance covers and how much money you’re going to have to put towards fertility treatments is imperative. You and your partner need to be on the same page regarding what your road to conception will be. 

 

References

Obstetrical and Gynecological Survey | The Impact of Adenomyosis on Women’s Fertility 2016 Sep; 71 (9): 57-568) published online 2016 Sept 12 | Taduka, Harada Md, Ph.D., SMSci, Yin Mon Khine, MB DS, Apostolos Kaponis, MD Ph.D., Theocharis Nikellis, MD, George Decavalos MD Ph.D., Fuminori Taniguchi MD PhD

 

Oxford Academic | Human Reproduction Open | The karate of Euploid Miscarriage is Increased in the Setting of Adenomyosis Vol 2018 Issue 3 published 04 July 2018 | V. Stanekova, RJ Woodman, K Tremellen

 

Science Direct | Taiwanese Journal of Obstetric and Gynecology | Uterine Sparing Surgery for Adenomyosis and/or Adenomyoma Volume 53 Issue I March 2014 pgs 3-7 | Huan-Cheng Horng, Ching Hui Chen, Uhhh Yao Chen, Kuan Has Tsui, Wei-Min Liu, Peng-Hui Wong, Wen-Hsun Chang, Ben Shian Huang, Hsu Dong Sun, Ting Chang Chang, Wei-Chun Chang, Ming-Shyen Yen

About the Author 

women's health and wellness blogger

Hi, my name is Kathleen but you can call me Kat. I’m a health and wellness professional turned freelance writer and content creator.  You can find me on  YouTube and Instagram. If you take the opportunity to visit me on my other platforms don’t hesitate to leave a message, I would love to hear from you!

 

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