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Fertile Discussions with Dr. Vaishali Chaudhary

Sunita, a young 32-year-old woman was referred to me for surrogacy and IVF as she had unfortunately got her uterus removed due to endometriosis.

Having No child and undergoing the removal of the uterus was a big decision that was shocking.

Her Mother said, “Doctor, she has suffered for many years and cried in pain. She would be like a fish out of water”.

We tried so many remedies. She has undergone surgery twice for the removal of the clots. We couldn’t watch her suffer anymore. Her husband also gave consent and we finally got her uterus removed as there seemed to be no other alternative.

But now, with no uterus, we have come for surrogacy”. Thus endometriosis damaged her uterus which left her with no other option but to consider surrogacy as her uterus had been removed

Let’s Find out more about Why is Endometriosis such a trouble-some disease

Endometriosis occurs when the tissue that is normally present inside the uterine cavity (the endometrium) gets deposited abnormally on the outer surface of the uterus and the surrounding organs like ovaries, fallopian tubes, behind the uterus, and sometimes on the intestines and urinary bladder.

So for 5 to 6 days of every month, along with the blood flow of the periods, similar bleeding happens on the abnormal areas wherever this tissue has got deposited.

This repeated bleeding causes severe inflammation in these areas. Endometriosis is called an enigmatic disease because it doesn’t follow any rules.

A woman with slight endometriosis can have a lot of pain and a woman with big areas of endometriosis may remain asymptomatic.

Though there are many theories, the most reliable theory believes that in some women, the blood flow during the periods can also happen backward through the uterus into the fallopian tubes and then into the pelvic cavity.

This leads to small areas of blood clots all around the uterus and the ovaries, which further leads to adhesions and abnormal fibrosis formation.

Another theory is that endometriosis has to do with changes in the immune system. Antibodies against endometrial cells can be found in the blood which then leads to an immune response and inflammation in the affected areas.

Environmental toxins and polychlorinated biphenyls (PCBs,) which act like hormones in the body and damage the immune system, can cause endometriosis, by damaging the immune system according to the Endometriosis Association.

The commonest symptoms can be very severe lower abdominal cramping pain during periods and deep-seated pain during intercourse.

Other complaints like Lower back pain, fatigue, and painful bowel motions are also seen. The pain associated with endometriosis can be extremely severe and may last for 10 days and may interfere with daily activities and routine work.

The bleeding that happens around the pelvic organs causes inflammation and adhesions which causes destruction of the ovarian tissue leading to a reduced number of eggs, poor-quality eggs, and impaired uptake of the eggs by the fallopian tubes.

The eggs may not be able to make very good-quality embryos due to prolonged inflammation. Usually in severe endometriosis, IVF is the best option.

Pain-killer Tablets, Progesterone tablets, Hormone injections, and sometimes laparoscopic surgery to remove big clots of blood which are called endometriomas are the current treatments available.

For young unmarried girls with severe endometriosis, harvesting of eggs by IVF and
freezing them for future use when the girl gets married and is ready for pregnancy can be thought of.

Dr. Vaishali Chaudhary is one of the leading IVF consultants practicing in Pune for the last 30 years.

Her interest in this subject led her to complete her Ph.D. in Female infertility and she can be consulted at Sahyadri Hospitals, Nagar Road Pune

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