Mild or moderate endometriosis only needs to be treated when the woman is suffering pain or where there is bad scarring or distortion of the tissues around the tubes and ovaries. Spots of endometriosis can be burned with diathermy (heat generated by a high frequency electric current) or a laser during laparoscopy. This approach can be a means of treating endometriosis that is causing cysts in the ovary. Between 30 and 70 percent of women will conceive after laparoscopic surgery.
Endometriosis grows under the influence of oestrogen. Drugs such as Buserelin that suppress ovarian activity also suppress endometriosis, and may avoid the need for surgery, but drugs can have unpleasant side effects. Also, conception is virtually impossible while they are being taken and endometriosis is likely to grow again soon after the treatment has been stopped for more than a few months.
Mild endometriosis will not benefit from surgery, and IVF may be the best option. When the endometriosis is more pronounced, IVF is not so successful and surgery may be worth considering. With IVF the hormonal stimulation of the ovaries may also cause the endometriosis to grow more vigorously. It is not uncommon, therefore, for women with endometriosis to have more pain after a failed IVF cycle. One paradox is that any treatment that results in pregnancy will help endometriosis to get better because during pregnancy hormones suppress the growth of all endometrial tissue.
Despite countless breakthroughs in medical science, we still do not understand why some pregnancies will end in tragedy. For most of us, having a child of our own is the most fulfilling experience of our lives. All of us can imagine the desperation and sadness of parents who lose a baby, and the life-shattering impact that a disabled or seriously ill child has on a family.
Professor Robert Winston’s Genesis Research Trust raises money for the largest UK-based collection of scientists and clinicians who are researching the causes and cures for conditions that affect the health of women and babies.
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