Recent large-scale studies show comorbidity (presence of both diseases at the same time) in women suffering from endometriosis or uterine fibroids, and suggest that it should be taken into account both for the diagnosis and treatment of fibroids and/or endometriosis.
La egg freezing It is recommended in the case of women with endometriosis, because it is a technique that allows us to be cautious and assures us have quality eggs if at any time we have problems obtaining eggs in a cycle of in vitro fertilization or if it is difficult for the woman to become pregnant and has to undergo an in vitro insemination cycle.
Today we know that women with endometriosis they may have a hard time getting pregnant, but there is really no way to predict which woman will have a hard time getting it.
There are doctors who venture to diagnose such difficulties and even to speak of infertility, but I would not dare to do so. I have seen cases of women who believed that they would not get pregnant and ended up staying quickly, and also of women who believed that they would not have difficulties and, in the end, they ended up going through numerous tests.
The best advice I can give you is not to be overwhelmed or worry, try it whenever you want, but since we do not know if a woman will want to have children at 30, 35 or 38, nor do we know if she will have had surgery or not , one option is freeze eggs.
IN WHICH CASES IS EGG FREEZING RECOMMENDED?
For a woman with deep endometriosis, with chocolate cysts on both ovaries, for example, I would strongly advise her to choose egg freezing before surgery.
Although the operations are done with laser and with great care, it is necessary to prevent possible unwanted effects.
In other cases, such as women who have already operated on one ovary and need to undergo surgery on the other, I also advise that eggs be frozen first, especially if their cysts are very large and the surgery is expected to be complicated. Because, although the operations are done with laser and with great care, it is necessary to prevent possible unwanted effects.
Egg freezing is the technique that allows us to be cautious: it ensures that we have six to eight quality eggs (which we can get in one or two stimulation cycles) to which to resort if at any time we have problems obtaining eggs or if it is difficult for the woman to become pregnant and has to undergo an in vitro fertilization cycle.
WHEN TO DO IT AND WHY DO WE FREEZE OVES AND NOT EMBRYOS?
There are very precise medical indications: women of 37 years maximum, with a good ovarian reserve. The quality of the ovarian reserve can be determined with an ultrasound, which allows to count the number of follicles that a woman has.
In addition, a blood test is done to determine the value of anti-Müllerian hormone, a hormone produced by the ovaries that has become the best marker of ovarian reserve. If that ultrasound and that antimullerian hormone give normal values, they indicate a good ovarian reserve.
We freeze eggs and not embryos because many times my patients do not have a partner, their partner is a woman or they are simply not sure that their current partner is the one they want to have children with.
If you have endometriosis and difficulties getting pregnant, the first thing to be clear about is that hormonal medical treatment for pain does not improve fertility, rather the opposite. Any such treatment will prevent you from getting pregnant while taking it.
Surgery is the only treatment capable of treating pain and infertility at the same time, but there are also cases in which endometrioma surgery makes pregnancy difficult.
There is only one treatment capable of treating pain and infertility at the same time: surgery. Women with endometriosis who do not become pregnant can increase their chances of pregnancy if all foci of endometriosis are removed.
I know it seems contradictory, but there are also cases in which endometrioma surgery makes pregnancy difficult: this occurs when surgery runs the risk of reducing ovarian reserve.
Therefore, it should be the doctor who advises on which is the best option in each case.
Extract from Endometriosis, the guide to understanding what it is and how to take care of yourself, the first guide to comprehensively treat endometriosis.
Dr Francisco Carmona