While many women with endometriosis experience a healthy pregnancy, others with the condition may experience an increased risk of pregnancy complications, which includes miscarriages. Read about how endometriosis may be linked to miscarriage and ways in which you could reduce this risk.
What is miscarriage?
Miscarriage is the spontaneous loss of the fetus before 20 weeks of pregnancy. Around 10 to 20% of known pregnancies end in miscarriage.
Most miscarriages happen because the fetus wasn’t developing normally or had chromosomal abnormalities (such as Down Syndrome) . The risk of chromosomal abnormalities increases as a woman’s age increases. However, there are also other factors that may increase the risk of miscarriage. These include autoimmune disease, obesity, certain viral and bacterial infections, smoking, and heavy drinking .
Symptoms of miscarriage include sharp pains, cramping, vaginal bleeding, and discharge of fluid or tissue from the vagina .
Does endometriosis increase the risk of miscarriage?
Research is ongoing to investigate the relationship between endometriosis and miscarriage.
A recent systematic review, which included 39 studies found that that woman with endometriosis had an increased risk of miscarriage (1.83 times increased risk) as compared to women without the disease if they conceived spontaneously. However, there was no increased risk of miscarriage if women with endometriosis conceived using assisted reproductive technology such as in vitro fertilization (IVF) or other methods .
How may endometriosis lead to miscarriage?
While the exact mechanism is not known, endometriosis-related structural changes such as endometriosis-associated inflammation or altered shape of the uterus due to lesions and scarring may affect the development of the fetus and the successful completion of the pregnancy [4,5].
How to reduce the risk of miscarriage?
You may be able to reduce your risk of miscarriage in the following ways:
Treatments before conception
Depending on your age and other factors, your doctor may suggest endometriosis treatments before you conceive that may help you achieve a successful pregnancy.
These treatments may include hormonal therapies to relieve symptoms, laparoscopic surgery to remove the endometriotic lesions around the uterus and ovaries, or the use of IVF to facilitate a successful pregnancy.
Reducing other risk factors
Lifestyle changes to reduce other risk factors of miscarriage include eating a healthy balanced diet, regular physical activity, managing other conditions such as obesity or diabetes, and avoiding smoking or alcohol .
Although endometriosis-associated inflammation may be associated with the higher miscarriage rate, taking anti-inflammatories is NOT recommended if you have already conceived. In fact, taking anti-inflammatories (Advil/Motrin, naproxen/Aleve, diclofenac) even before conception (near the time of ovulation), may inhibit ovulation itself as it relies on an inflammatory process to release the egg .
If you have endometriosis and are pregnant, your doctor should closely monitor the course of your pregnancy, especially in the first trimester . If you have any symptoms similar to those of a miscarriage, seek medical help immediately.
- Miscarriage, Mayo Clinic
- Miscarriage, NHS
- Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis, BioMed Researcn International
- Optimal uterine anatomy and physiology necessary for normal implantation and placentation, Fertility and Sterility
- Increased rate of spontaneous miscarriages in endometriosis-affected women, Human Reproduction
- Non-steroidal anti-inflammatory drugs (NSAIDs) and ovulation: lessons from morphology, Histology and Histopathology
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