Here’s How Endometriosis Affects Pregnancy

Photographed by Ashley Armitage.
It's largely known that endometriosis can affect your ability to get pregnant. Though it's not always the case, the condition has been linked to a higher risk for infertility because it may influence egg quality, mess with your menstrual cycle, or cause higher levels of inflammation.
And just last month, Lena Dunham revealed that, after a painful battle with the condition and its complications, she opted to undergo a hysterectomy, which involves removing the cervix and uterus, making it physically impossible to carry children.
But if you have endometriosis and are able to conceive, are there pregnancy complications you should be worried about? Fortunately, as it turns out, there aren't too many.
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"A major challenge is just getting pregnant, and then once people with endometriosis do become pregnant, they generally tend to do well," says Mara Rosner, MD, assistant professor in the Department of Obstetrics and Gynecology at NYU Langone.
Endometriosis, a condition in which the lining of your uterus (or endometrial lining) grows outside the uterus on other parts of your body, is diagnosed using stages of severity. The first and second stages are generally thought to be more mild forms of the disease, while the third and fourth stages are more difficult to live with, and can involve more scar tissue and cysts around the ovaries and/or fallopian tubes. Those who have it and are able to get pregnant usually have a mild form of the condition. They may have an easier time conceiving than those who have a more severe case, Dr. Rosner says.
If someone with severe endometriosis is able to become pregnant, they may experience birth difficulties if they have a C-section — especially if they've had several surgeries related to the condition (often to remove scar tissue or endometriosis-affected tissue).

A major challenge is just getting pregnant, and then once people with endometriosis do become pregnant, they generally tend to do well.

Mara Rosner, MD
"If there’s substantial scar tissue and cysts, and they have a history of many surgeries, their anatomy can be somewhat unusual, and that can make operating more difficult," Dr. Rosner says.
Other than that, Dr. Rosner says she could imagine a scenario in which endometriosis might affect the size of a pregnant person's belly, but that it isn't a serious concern.
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Because endometrial tissue can be sticky, she says, it can cause organs to stick together. So if someone has a lot of endometriosis in the back of the uterus, for example, it might result in the belly looking different.
"It’s not something that we would warn a patient about because, the truth is, everybody’s belly is different during pregnancy," she says.
Overall, Dr. Rosner says, once a person with endometriosis is able to get pregnant, they've generally tackled the biggest hurdle, and they typically don't have complicated pregnancies. But as always, if you have some concerns about your pregnancy, it's best to check with your doctor — whether or not you have endometriosis.
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